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Experience with one and a half ventricle repair.
C Kreutzer1, R C Mayorquim, G O Kreutzer
1Divisions of Cardiovascular Surgery and Cardiology, Ricardo Gutierrez Children's Hospital, Cardiovascular Surgery, Bazterrica Clinic, Buenos Aires, Argentina.
The Journal of Thoracic and Cardiovascular Surgery
|March 30, 1999
Summary
This study shows that one and a half ventricle repair is a viable treatment for right ventricular hypoplasia or dysfunction, offering good early and intermediate outcomes. Further long-term data is needed for complete evaluation.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Congenital Heart Disease
Background:
- Right ventricular hypoplasia or dysfunction presents complex challenges in congenital heart disease management.
- The one and a half ventricle repair strategy aims to address these anatomical and functional abnormalities.
Purpose of the Study:
- To evaluate the 10-year experience with the one and a half ventricle repair procedure.
- To assess the efficacy and outcomes of this surgical approach for patients with functionally abnormal right ventricles.
Main Methods:
- A cohort of 30 patients with various diagnoses underwent bidirectional Glenn shunt as part of the repair between 1986 and 1996.
- Multiple concomitant cardiac procedures were performed, including atrial septal defect closure, right ventricular augmentation, and outflow tract enlargement.
Main Results:
- The study reported an early mortality of 6.6% and a late mortality of 3.3%.
- Mean oxygen saturations remained stable at 1 and 5 years post-procedure (approximately 93.5%).
- Five-year survival was 90%, with a significant majority of patients in New York Heart Association functional class I or II.
Conclusions:
- The one and a half ventricle repair serves as a valid alternative for correcting right ventricle hypoplasia or dysfunction.
- Early and intermediate results are comparable to the Fontan procedure, though long-term follow-up is essential.