Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-19T04:45:30.275Z Has data issue: false hasContentIssue false
  • English
  • Français

Indications, criterions, and principles for biventricular repair

Published online by Cambridge University Press:  21 September 2005

Christo I. Tchervenkov
Christo I. Tchervenkov
Affiliation:
Department of Cardiovascular Surgery, The Montreal Children's Hospital, Montreal, Canada
Get access Rights & Permissions [Opens in a new window]

Extract

The hypoplastic left heart syndrome constitutes a wide spectrum of cardiac malformations, characterized by varying degrees of underdevelopment of the structures of the left heart and aortic arch. At the severe end of the spectrum, there is aortic and mitral atresia, and the left ventricle is vestigial. In contrast, at the mild end, there is hypoplasia of the left ventricle in the absence of overt stenosis of either the aortic or mitral valves, the combination we have described as hypoplastic left heart complex.1 Until recently, debate with regard to the optimal surgical approach has centered on the choice between the Norwood operation and neonatal cardiac transplantation. In the last several years, nonetheless, it has been shown that of biventricular repair can be achieved in those patients at the favorable end of the spectrum that we designated as having the complex rather than the syndrome.1,2 It is well recognized that an ongoing difficulty is the inconsistent and imprecise definition of hypoplastic left heart syndrome. In this presentation, I summarize our own criterions, and our principles for biventricular repair, as based on our experience at the Montreal Children's Hospital, for those patients we judge to have the hypoplastic left heart complex.

Type
Biventricular Repair
Information
Cardiology in the Young , Volume 14 , Issue S1 , February 2004 , pp. 97 - 100
Copyright
© 2004 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Tchervenkov CI, Tahta SA, Jutras LC, Beland MJ. Biventricular repair in neonates with hypoplastic left heart complex. Ann Thorac Surg 1998; 66: 1350–1357.Google Scholar
Tchervenkov CI. Two-ventricle repair for hypoplastic left heart syndrome. Semin Thorac Cardiovasc Surg Pediatric Card Surg Annu 2001; 4: 83–93.Google Scholar
Tchervenkov CI, Jacobs ML, Tahta SA. Congenital heart surgery nomenclature and database project: hypoplastic left heart syndrome. Ann Thorac Surg 2000; 69: S170–S179.Google Scholar
Norwood WI, Lang P, Hansen DD. Physiologic repair of aortic atresia – hypoplastic left heart syndrome. N Engl J Med 1983; 308: 23–26.Google Scholar
Bailey LL, Nehlsen-Cannarella SL, Doroshow RW, Jacobson JG, Martin RD, Allard MW, Hyde MR, Dang Bui RH, Petry EL. Cardiac allotransplantation in newborns as therapy for hypoplastic left heart syndrome. N Engl J Med 1986; 315: 949–951.Google Scholar
Rhodes LA, Colan SD, Perry SB, Jonas RA, Sanders SP. Predictors of survival in neonates with critical aortic stenosis. Circulation 1991; 84: 2325–2335.Google Scholar
van Son JA, Phoon CK, Silverman NH, Haas GS. Predicting feasibility of biventricular repair of right-dominant unbalanced atrioventricular canal. Ann Thorac Surg 1997; 63: 1657–1663.Google Scholar
Lofland GK, McCrindle BW, Williams WG, Blackstone EH, Tchervenkov CI, Jonas RA, Sittiwangkul R. Critical aortic stenosis in the neonate: a multi-institutional study of management, outcomes, and risk factors. Congenital Heart Surgeons' Society. J Thorac Cardiovasc Surg 2001; 121: 10–27.Google Scholar
Page DA, Levine MM. Left ventricular growth in a patient with critical coarctation of the aorta and hypoplastic left ventricle. Pediatr Cardiol 1995; 16: 176–178.Google Scholar
Kovalchin JP, Brook MM, Silverman NH. Growth of the hypoplastic left ventricle? Pediatr Cardiol 1997; 18: 451–452.Google Scholar
Minich LL, Tani LY, Hawkins JA, Shaddy RE. Possibility of postnatal left ventricular growth in selected infants with non-apex-forming left ventricles. Am Heart J 1997; 133: 570–574.Google Scholar
Serraf A, Piot JD, Bonnet N, Lacour-Gayet F, Touchot A, Bruniaux J, Belli E, Galletti L, Planche C. Biventricular repair approach in ducto-dependent neonates with hypoplastic but morphologically normal left ventricle. J Am Coll Cardiol 1999; 33: 827–834.Google Scholar
Tani LY, Minich LL, Pagotto LT, Shaddy RE, McGough EC, Hawkins JA. Left heart hypoplasia and neonatal aortic arch obstruction: is the Rhodes left ventricular adequacy score applicable? J Thorac Cardiovasc Surg 1999; 118: 81–86.Google Scholar
Alboliras ET, Mavroudis C, Pahl E, Gidding SS, Backer CL, Rocchini AP. Left ventricular growth in selected hypoplastic left ventricles: outcome after repair of coarctation of aorta. Ann Thorac Surg 1999; 68: 549–555.Google Scholar
Foker JE, Berry J, Steinberger J, et al. The forward flow signal for growth of hypoplastic ventricles. Circulation 1997; 96: I435.Google Scholar
Tchervenkov CI, Chu VF, Shum-Tim D, Laliberte E, Reyes TU. Norwood operation without circulatory arrest: a new surgical technique. Ann Thorac Surg 2000; 70: 1730–1733.Google Scholar
Tchervenkov CI, Korkola SJ, Shum-Tim D. Surgical technique to avoid circulatory arrest and direct arch vessel cannulation during neonatal aortic arch reconstruction. Eur J Cardiothorac Surg 2001; 19: 708–710.Google Scholar
Tchervenkov CI, Korkola SJ, Shum-Tim D, Calaritis C, Laliberte E, Reyes TU, Lavoie J. Neonatal aortic arch reconstruction avoiding circulatory arrest and direct arch vessel cannulation. Ann Thorac Surg 2001; 72: 1615–1620.Google Scholar