RT Journal Article SR Electronic T1 Ventricular function and vascular dimensions after Norwood and hybrid palliation of hypoplastic left heart syndrome JF Heart JO Heart FD BMJ Publishing Group Ltd and British Cardiovascular Society SP 244 OP 252 DO 10.1136/heartjnl-2017-311532 VO 104 IS 3 A1 Heiner Latus A1 Mohamed S Nassar A1 James Wong A1 Pauline Hachmann A1 Hannah Bellsham-Revell A1 Tarique Hussain A1 Christian Apitz A1 Caner Salih A1 Conal Austin A1 David Anderson A1 Can Yerebakan A1 Hakan Akintuerk A1 Juergen Bauer A1 Reza Razavi A1 Dietmar Schranz A1 Gerald Greil YR 2018 UL http://heart.bmj.com/content/104/3/244.abstract AB Objective Norwood and hybrid procedure are two options available for initial palliation of patients with hypoplastic left heart syndrome (HLHS). Our study aimed to assess potential differences in right ventricular (RV) function and pulmonary artery dimensions using cardiac magnetic resonance (CMR) in survivors with HLHS.Methods 42 Norwood (mean age 2.4±0.8) and 44 hybrid (mean age 2.0±1.0 years) patients were evaluated by CMR after stage II palliation prior to planned Fontan completion. Initial stage I Norwood procedure was performed using a modified Blalock-Taussig shunt, while the hybrid procedure consisted of bilateral pulmonary artery banding and arterial duct stenting. Need for reinterventions and subsequent outcomes were also assessed.Results Norwood patients had larger RV end-diastolic dimensions (91±23 vs 80±31 mL/m2, p=0.004) and lower heart rate (90±15 vs 102±13, p<0.001) than hybrid patients. Both Norwood and hybrid patients showed preserved global RV pump function (59±9 vs 59%±10%, p=0.91), while RV strain, strain rate and intraventricular synchrony were superior in the Norwood group. Pulmonary artery size was reduced (lower lobe index 135±74 vs 161±62 mm2/m2, p=0.02), and reintervention rate was significantly higher in the hybrid group whereas subsequent outcome did not differ significantly (p=0.24).Conclusions Norwood and hybrid strategy were associated with equivalent and preserved global RV pump function while development of the pulmonary arteries and reintervention rate were superior using the Norwood approach. Impaired RV myocardial deformation as a potential marker of early RV dysfunction in the hybrid group may have a negative long-term impact in this population.