Keywords
Hybrid procedure
Norwood
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Abstract
Objective: To compare characteristics, clinical outcomes, and the safety of the hybrid procedure and the Norwood surgery as the first-stage treatment for Hypoplastic Left Heart Syndrome (HLHS). Methods: This is an integrative review. Original studies with quantitative or qualitative approaches published between 2015 and 2025 were included. Data collection was performed in the PubMed, Web of Science, and LILACS databases. The search strategy followed the PICO methodology (Population, Interest, Context). Results: The systematic review included 10 studies on neonates with hypoplastic left heart syndrome who underwent Norwood surgery or hybrid palliation. The Norwood procedure remains predominant, with progressively reduced hospital mortality in experienced centers, while the hybrid approach is indicated for high-risk patients, showing reasonable early survival, less invasiveness, but greater need for reinterventions. The therapeutic choice depends on anatomical, clinical, and institutional factors, including surgical experience and postoperative support. Despite differences in mortality and complications, both procedures can improve survival, making individualized selection essential. Final considerations: The Norwood procedure remains the standard for HLHS, while the hybrid approach is a less invasive alternative for high-risk neonates, requiring individualized decision-making based on clinical profile and institutional expertise.
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