Long-term results of biventricular repair after initial Giessen hybrid approach for hypoplastic left heart variants Can Yerebakan, MD, Josephine Murray,

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Long-term results of biventricular repair after initial Giessen hybrid approach for hypoplastic left heart variants Can Yerebakan, MD, Josephine Murray, MS, Klaus Valeske, MD, Josef Thul, MD, Hatem Elmontaser, MD, Matthias Mueller, MD, Valesco Mann, MD, Stefan Ostermayer, MD, Heiner Latus, MD, Christian Apitz, MD, Dietmar Schranz, MD, Hakan Akintuerk, MD The Journal of Thoracic and Cardiovascular Surgery Volume 149, Issue 4, Pages 1112-1122.e2 (April 2015) DOI: 10.1016/j.jtcvs.2014.09.028 Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Hypoplastic left heart diagnoses within the group of the patients who received biventricular correction. HLHS, Hypoplastic left heart syndrome; AS, aortic stenosis; MS, mitral stenosis; D-TGA, d-transposition of the great arteries; IAA, interrupted aortic arch; HLHC, hypoplastic left heart complex; DORV, double-outlet right ventricle; hypAoA, hypoplastic aortic arch; iAVSD, imbalanced atrioventricular septal defect; EFE, endocardial fibroelastosis; CoA, coarctation. The Journal of Thoracic and Cardiovascular Surgery 2015 149, 1112-1122.e2DOI: (10.1016/j.jtcvs.2014.09.028) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 A, Kaplan–Meier survival analysis for patients with HLHC and variants after biventricular correction. B, Freedom from subsequent surgery or intervention for patients after biventricular correction. BVC, Biventricular correction. The Journal of Thoracic and Cardiovascular Surgery 2015 149, 1112-1122.e2DOI: (10.1016/j.jtcvs.2014.09.028) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Scatter and box plots showing the development of aortic and mitral valve Z scores and their diameters in comparison of time points before hybrid stage I and before biventricular correction. Numbers below the plots represent the median (minimum and maximum) for each parameter. Each patient is symbolized with filled circle in the upper 2 figures. In the lower figures, different types of symbols (filled/unfilled and shapes) are used to identify patients before stage I, and the values correspond to the measurements before biventricular correction. Stage I, Hybrid stage I; BVC, biventricular correction. *P < .05. The Journal of Thoracic and Cardiovascular Surgery 2015 149, 1112-1122.e2DOI: (10.1016/j.jtcvs.2014.09.028) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 LV/RV length ratio (A) and application of the discriminant score (B) by Colan and colleagues2 to our cohort before hybrid stage I and before biventricular correction. Red line represents the critical cutoff of −0.65 above which a biventricular correction is favorable. Numbers below the plots indicate the median (minimum and maximum) for each parameter. Each patient is represented by a filled circle in (A). In (B), different types of symbols (filled/unfilled and shapes) are used to identify patients before stage I and the values correspond to the measurements before biventricular correction. LV, Left ventricle; RV, right ventricle; Stage I, hybrid stage I; BVC, biventricular correction. *P < .05. The Journal of Thoracic and Cardiovascular Surgery 2015 149, 1112-1122.e2DOI: (10.1016/j.jtcvs.2014.09.028) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions