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Borderline left ventricle.

Antonio F Corno1

  • 1Department of Cardiothoracic Surgery, Alder Hey Royal Children Hospital, Liverpool, L12 2AP, UK. antonio.corno@rlc.nhs.uk

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|December 29, 2004
PubMed
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Defining a borderline left ventricle is crucial for surgical planning in congenital heart defects. Comprehensive morphometric and functional assessments guide decisions between uni- or biventricular repair for better outcomes.

Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Surgery
  • Cardiovascular Imaging

Background:

  • The 'borderline left ventricle' presents a significant challenge in pediatric cardiology and cardiac surgery.
  • Accurate pre-operative assessment is vital to determine the left ventricle's adequacy for systemic circulation, influencing surgical repair strategies.

Purpose of the Study:

  • To review and define the morphometric and functional parameters used to evaluate a borderline left ventricle.
  • To outline the decision-making process for surgical repair (uni- vs. biventricular) in patients with a borderline left ventricle.

Main Methods:

  • Comprehensive review of morphometric parameters including ventricular dimensions, valve areas, and wall thickness.
  • Inclusion of functional parameters such as ejection fraction, pressures, and blood flow patterns.

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  • Analysis of hemodynamic data and available surgical options.

    • Main Results:

    • Identified key morphometric and functional indicators for assessing left ventricular adequacy.
    • Highlighted the complexity of decision-making in four specific congenital heart defect groups: aortic valve stenosis, coarctation, hypoplastic left heart complex, and RV overload.
    • Emphasized the integration of patient-specific data, surgical options, and institutional experience.

    Conclusions:

    • A precise definition and thorough evaluation of borderline left ventricles are essential for optimal surgical planning.
    • The decision for uni- or biventricular repair requires a multi-faceted approach considering all available parameters.
    • This review provides a framework for managing complex cases of borderline left ventricle in pediatric congenital heart disease.