Alternative hybrid and staged interventional treatment of congenital heart defects in critically ill children with complex and non-cardiac problems

Ireneusz Haponiuk; Maciej Chojnicki; Radosław Jaworski; Mariusz Steffens; Aneta Szofer-Sendrowska; Konrad Paczkowski; Ewelina Kwaśniak; Jacek Zieliński; Katarzyna Gierat-Haponiuk; Katarzyna Leszczyńska

doi:10.5114/wiitm.2015.49474

eISSN: 2299-0054
ISSN: 1895-4588

Videosurgery and Other Miniinvasive Techniques

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2/2015
vol. 10

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abstract:

Original paper

Alternative hybrid and staged interventional treatment of congenital heart defects in critically ill children with complex and non-cardiac problems

Ireneusz Haponiuk

,

Maciej Chojnicki

,

Radosław Jaworski

,

Mariusz Steffens

,

Aneta Szofer-Sendrowska

,

Konrad Paczkowski

,

Ewelina Kwaśniak

,

Jacek Zieliński

,

Katarzyna Gierat-Haponiuk

,

Katarzyna Leszczyńska

Videosurgery Miniinv 2015; 10 (2): 244–256

DOI: https://doi.org/10.5114/wiitm.2015.49474

Online publish date: 2015/02/25

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AMA

Haponiuk I, Chojnicki M, Jaworski R, et al. Alternative hybrid and staged interventional treatment of congenital heart defects in critically ill children with complex and non-cardiac problems. Videosurgery and Other Miniinvasive Techniques. 2015;10(2):244-256. doi:10.5114/wiitm.2015.49474.

APA

Haponiuk, I., Chojnicki, M., Jaworski, R., Steffens, M., Szofer-Sendrowska, A.,  & Paczkowski, K. et al. (2015). Alternative hybrid and staged interventional treatment of congenital heart defects in critically ill children with complex and non-cardiac problems. Videosurgery and Other Miniinvasive Techniques, 10(2), 244-256. https://doi.org/10.5114/wiitm.2015.49474

Chicago

Haponiuk, Ireneusz, Maciej Chojnicki, Radosław Jaworski, Mariusz Steffens, Aneta Szofer-Sendrowska, Konrad Paczkowski,  and Ewelina Kwaśniak et al. 2015. "Alternative hybrid and staged interventional treatment of congenital heart defects in critically ill children with complex and non-cardiac problems". Videosurgery and Other Miniinvasive Techniques 10 (2): 244-256. doi:10.5114/wiitm.2015.49474.

Harvard

Haponiuk, I., Chojnicki, M., Jaworski, R., Steffens, M., Szofer-Sendrowska, A., Paczkowski, K., Kwaśniak, E., Zieliński, J., Gierat-Haponiuk, K.,  and Leszczyńska, K. (2015). Alternative hybrid and staged interventional treatment of congenital heart defects in critically ill children with complex and non-cardiac problems. Videosurgery and Other Miniinvasive Techniques, 10(2), pp.244-256. https://doi.org/10.5114/wiitm.2015.49474

MLA

Haponiuk, Ireneusz et al. "Alternative hybrid and staged interventional treatment of congenital heart defects in critically ill children with complex and non-cardiac problems." Videosurgery and Other Miniinvasive Techniques, vol. 10, no. 2, 2015, pp. 244-256. doi:10.5114/wiitm.2015.49474.

Vancouver

Haponiuk I, Chojnicki M, Jaworski R, Steffens M, Szofer-Sendrowska A, Paczkowski K et al. Alternative hybrid and staged interventional treatment of congenital heart defects in critically ill children with complex and non-cardiac problems. Videosurgery and Other Miniinvasive Techniques. 2015;10(2):244-256. doi:10.5114/wiitm.2015.49474.

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Introduction: An individually designed strategy of comprehensive alternative hybrid and staged interventional treatment (AHASIT) can be a reasonable alternative to conventional treatment of congenital heart defects, reduce the risk of cardiac surgery or interventions performed separately, and give an additional chance for critically ill children.

Aim: To present our experience and the results of AHASIT of severely ill or borderline children referred for surgery with the diagnosis of congenital heart defects.

Material and methods: A group of 22 patients with complex cardiac and non-cardiac pathologies was retrospectively selected and analyzed. An individual preoperative severity scale was established for AHASIT patients, with one point for each of the following preoperative complications: prematurity, low body weight, cyanosis, intolerance to drug therapy, failed interventional treatment prior to admission, mechanical ventilation prior to the procedure, chronic respiratory failure and non-cardiac, mainly congenital malformations (congenital diaphragmatic hernia, lower extremity agenesia, duodenal atresia) and acquired problems (newborn edema, necrotic enterocolitis, intracranial hemorrhage, liver and renal failure, anemia and thrombocytopenia, infections or colonization with drug-resistant pathogens).

Results: The analysis of the postoperative course showed that the patients with 5 AHASIT points or more had a more complicated postoperative course than the patients with 1 to 4 AHASIT points.

Conclusions: The AHASIT of pediatric congenital heart defects with complex and non-cardiac problems appeared to be an attractive option for selected severely ill patients. The strategy was found to be effective in selected neonates suffering from complex and accompanying non-cardiac pathologies, with positive final results of both cardiological intervention and planned surgery.

keywords:

Alternative hybrid and staged interventional treatment of congenital heart defects in critically ill children with complex and non-cardiac problems

Ireneusz Haponiuk , Maciej Chojnicki , Radosław Jaworski , Mariusz Steffens , Aneta Szofer-Sendrowska , Konrad Paczkowski , Ewelina Kwaśniak , Jacek Zieliński , Katarzyna Gierat-Haponiuk , Katarzyna Leszczyńska

cardiac surgery, interventional cardiology, transcatheter, hybrid technique, newborn

Ireneusz Haponiuk

,

Maciej Chojnicki

,

Radosław Jaworski

,

Mariusz Steffens

,

Aneta Szofer-Sendrowska

,

Konrad Paczkowski

,

Ewelina Kwaśniak

,

Jacek Zieliński

,

Katarzyna Gierat-Haponiuk

,

Katarzyna Leszczyńska