An animal model for hybrid stage I palliation of hypoplastic left heart syndrome.

Hybrid palliation has evolved as an important alternative treatment strategy for patients with hypoplastic left heart syndrome (HLHS). The procedural cooperation between cardiothoracic surgeon and interventional cardiologist is not intuitive and there is an increasing demand to avoid mistakes of the 'early learning curve,' through in vivo teaching using an animal model. We describe a unique experience of developing a piglet model that can be used to teach the procedural technique of hybrid Stage I palliation. The model has been used in about 140 piglets and consists of percutaneous patent ductus arteriosus (PDA) balloon angioplasty using a 6-mm balloon in piglets with a weight of 2-2.5 kg, followed within 4-7 days by bilateral PA banding as well as PDA stent placement in a hybrid procedure through a midline sternotomy.