On November 5, 2025, an important milestone was achieved for Georgian pediatric
cardiology when a medical research paper by Dr. Nikoloz Labartkava, titled “Hybrid
Procedures in the Management of Hypoplastic Left Heart Syndrome,” was published by
Cambridge University Press in Cardiology in the young. one of the world’s leading
medical-scientific journals. This journal is widely recognized for its excellence in congenital and pediatric cardiovascular. medicine. The article, “Hybrid Procedures in the Management of Hypoplastic Left Heart Syndrome,” is the first study by a Georgian author in the field of pediatric interventional cardiology to be published in an internationally recognized journal.

Dr. Labartkava conducted this research in Italy, at the University of Bergamo and the
Bambino Gesù Pediatric Hospital in Rome. He holds an international Master’s degree in
cardiology and cardiac surgery techniques, jointly awarded by the University of Bergamo
and the University of Milano-Bicocca. This publication is significant not only for its scientific contribution but also because it highlights the ability of Georgian researchers to advance pediatric interventional cardiology in Georgia and to contribute meaningfully to global discourse in the field.

The Study and Its Scientific Significance

Hypoplastic left heart syndrome (HLHS) remains one of the most complex and high-risk
congenital heart defects, accounting for approximately 2–3% of all congenital heart
malformations. The Norwood procedure is considered the standard palliative treatment approach. It involves extensive surgical reconstruction during the very first days of life. Despite improvements achieved over decades, this procedure still carries substantial risks due to its invasive nature and the challenges of cardiopulmonary bypass in neonates, including early mortality and neurological complications.
In recent years, hybrid procedures have emerged as a potential alternative to the Norwood
procedure. Hybrid approaches combine limited surgical and interventional (minimally
invasive) techniques, such as bilateral pulmonary artery banding and stenting of the patent
ductus arteriosus.

Dr. Labartkava’s work brings together eleven (11) major international studies involving a
total of 934 neonates with HLHS, of whom 371 underwent the hybrid procedure and 563
underwent the Norwood procedure. The study is a high-quality, reliable, and well-structured synthesis that analyzes the effectiveness and safety of hybrid approaches, specifically their mortality rates and long-term outcomes in the management of HLHS.
The analysis showed that long-term survival rates at one, three, and five years were
comparable between hybrid procedures and traditional surgical methods. It also found no
significant difference in mortality between the hybrid and Norwood procedures when
adjusted for neonatal weight.The publication further emphasized the necessity of
standardized protocols, refinement of patient-selection criteria, and additional long-term
research aimed at optimizing outcomes.
By consolidating existing data within a comparative framework, this systematic review fills
an important gap in the current literature. Dr. Nikoloz Labartkava’s research represents a
practically valuable overview that will contribute meaningfully to contemporary knowledge
in pediatric interventional cardiology.

Significance of the Study for Georgia

The publication of a Georgian physician’s research in Cardiology in the Young marks a
significant milestone for the country’s medical and scientific community. It reflects the
ongoing development of the field in Georgia and demonstrates the successful integration of
Georgian researchers into the global academic sphere. This achievement sets an important
precedent for the future international recognition of Georgian physicians.
For Georgian pediatric interventional cardiology, this accomplishment represents tangible
progress in both scientific capacity and clinical advancement. By examining the role of
hybrid procedures in the management of congenital heart defects, the study helps raise
awareness of minimally invasive techniques within Georgia and underscores the importance
of multidisciplinary collaboration among cardiologists, cardiac surgeons, and
anesthesiologists. Moreover, the publication serves as an inspiring example for young Georgian physicians and researchers. It demonstrates that academic rigor, dedication, and adherence to international standards can lead to impactful, globally recognized contributions.