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should we attempt functionally univentricular or partial biventricular repair for patients with complex congenital cardiac anomalies and hypoplasia of the subpulmonary ventricle?

Published online by Cambridge University Press:  23 September 2005

vladimiro l. vida
Affiliation:
department of cardiovascular surgery, paediatric cardiac surgery unit, university of padova medical school, padova, italy
maurizio rubino
Affiliation:
department of cardiovascular surgery, paediatric cardiac surgery unit, university of padova medical school, padova, italy
tomaso bottio
Affiliation:
department of cardiovascular surgery, paediatric cardiac surgery unit, university of padova medical school, padova, italy
ornella milanesi
Affiliation:
paediatrics, university of padova medical school, padova, italy
giorgio pittarello
Affiliation:
anaesthesia, university of padova medical school, padova, italy
giovanni stellin
Affiliation:
department of cardiovascular surgery, paediatric cardiac surgery unit, university of padova medical school, padova, italy

Abstract

hypoplasia, with or without dysplasia, of the subpulmonary ventricle is found in association with a wide spectrum of complex congenital cardiac anomalies. in these cardiac defects, the systemic ventricle is usually normal, while the subpulmonary one, usually of right morphology, is incapable of supporting the entire flow of blood to the lungs. there is now an alternative to the more classical functionally univentricular type of repair, which can be achieved by means of the total cavopulmonary connection, namely the partial biventricular, or the so called “one and a half ventricle” repair. in selected cases, by reducing the preload on the subpulmonary ventricle by construction of a bi-directional cavo-pulmonary shunt, it is possible to achieve complete separation of the pulmonary and systemic circulations, whilst still maintaining pulsatile flow of blood to the lungs. in this review, we describe our experience with the “one-and-a-half ” ventricular option, analysing the role of preoperative evaluation of the subpulmonary ventricle, and describing our results over the short and intermediate term.

Type
original article
Copyright
2004 cambridge university press

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