Evolution of hybrid interventions for congenital heart disease.

INTRODUCTION: Surgical and transcatheter interventions have seen a tremendous evolution in last three decades. Hybrid technology combines the achievements of both disciplines to bring substantial hemodynamic benefit to patients with congenital heart disease (CHD) in a minimally invasive manner. This collaboration between surgeons and interventionalists will continue to grow as the technology evolves to meet the demands of CHD patients, potentially avoiding cardiopulmonary bypass and vascular access complications as well as optimizing immediate technical outcomes with exit angiography. Areas covered: This review covers application of such technology to initial palliation of infants with hypoplastic left heart syndrome, ventricular septal defect closure, pulmonary atresia with intact ventricular septum, pulmonary valve replacement, intra-operative pulmonary artery stenting and vascular cut-down in small neonates. Expert commentary: Careful planning and investment in infrastructure is necessary to optimize outcomes, however patients can benefit tremendously from integration of this approach into clinical practice.