09:25 〜 11:15
[II-S02-02] Hybrid Strategies to treat Heart failure
Heart failure (HF) in children ranges from an obvious isolated left ventricular (LV) systolic dysfunction to a discrete right ventricular (RV) diastolic dysfunction; HF might be associated with left or right ventricular failure or both but even with congenital heart defects, arrhythmias or secondary to pulmonary or systemic circulatory diseases. The severity of ventricular failure is still defined best by the clinical functional status. Indicating morphological, functional and molecular parameters an advanced ventricular failure, despite improvements in medical therapy the overall prognosis of patients with severe heart failure remains poor. Orthotopic heart transplantation (HTX) is the final pathway but if, only the final chance for a minority.
Presented are novel interventional - surgical strategies from diastolic device in out-of-proportion left atrial pressure to reversible pulmonary artery banding (rPAB) in left ventricular dilative cardiomyopathy (LV-DCM) with preserved right ventricular function, to Hybrid procedure combining atrio-septostomy and reversed Potts-shunt physiology (back to the fetal circulation) by transcatheter or surgical interventions in patients with morphological and/or functional LV as well as RV failure. In addition, the option is discussed to change a “VSD”-Eisenmenger to a PDA-Eisenmenger by surgical correction combined with reverse Potts-Shunt.
It is hypothesized that these novel Interventional-Surgical and Hybrid techniques might be able to bridge patients longer with severe heart failure to transplantation or might be even an alternative for HTX or heart-lung transplantation, respectively.
Presented are novel interventional - surgical strategies from diastolic device in out-of-proportion left atrial pressure to reversible pulmonary artery banding (rPAB) in left ventricular dilative cardiomyopathy (LV-DCM) with preserved right ventricular function, to Hybrid procedure combining atrio-septostomy and reversed Potts-shunt physiology (back to the fetal circulation) by transcatheter or surgical interventions in patients with morphological and/or functional LV as well as RV failure. In addition, the option is discussed to change a “VSD”-Eisenmenger to a PDA-Eisenmenger by surgical correction combined with reverse Potts-Shunt.
It is hypothesized that these novel Interventional-Surgical and Hybrid techniques might be able to bridge patients longer with severe heart failure to transplantation or might be even an alternative for HTX or heart-lung transplantation, respectively.