Commentary: Palliation pit stop

Despite improvements in surgical technique and medical care, 1-year transplant-free survival rates for newborns with hypoplastic left heart syndrome continue to approximate 70%.1 Bilateral pulmonary artery banding with ductal stenting (hybrid palliation) was initially developed to alter this paradigm by avoiding cardiopulmonary bypass and circulatory arrest in the neonatal period.2 Reported results for this strategy are either equivalent or inferior to Norwood.3 Most centers use the hybrid procedure selectively for high-risk patient populations.