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Updated: Mar 17, 2026

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Right ventricular centripetal plication: an aggressive right ventricular exclusion technique.

Junya Sugiura1, Hiroomi Murayama2, Noritaka Okada2

  • 1Department of Cardiovascular Surgery, Aichi Children's Health and Medical Center, Ohbu, Aichi, Japan junyafine@hotmail.com.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|July 23, 2016
PubMed
Summary

Right ventricular compression can impair left ventricular function in single ventricle patients. Inside-out right ventricular plication successfully excluded the right ventricle, improving outcomes.

Keywords:
Ebstein's anomalyPulmonary atresia with intact ventricular septum

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Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Congenital Heart Disease

Background:

  • Functional single ventricle physiology presents unique challenges.
  • Right ventricular (RV) volume or pressure overload can compress the left ventricle (LV), impairing LV performance.
  • Conditions like neonatal Ebstein's anomaly and pulmonary atresia with intact ventricular septum exemplify this issue.

Purpose of the Study:

  • To describe a novel surgical technique for managing RV overload in single ventricle physiology.
  • To evaluate the efficacy of inside-out right ventricular centripetal plication in mitigating LV compression.
  • To assess the impact of this procedure on LV function and patient outcomes.

Main Methods:

  • A cohort of patients with functional single ventricle physiology and RV overload was identified.
  • The surgical procedure involved right ventricular centripetal plication performed from the endocardial (inside) surface.
  • The technique aimed to exclude the enlarged RV, thereby reducing its compressive effect on the LV.

Main Results:

  • The right ventricular centripetal plication procedure was successfully performed in the studied patients.
  • The technique effectively excluded the right ventricle, minimizing its adverse impact on the left ventricle.
  • Post-operative results were deemed satisfactory, indicating improved ventricular interaction and function.

Conclusions:

  • Inside-out right ventricular centripetal plication is a viable surgical option for functional single ventricle patients with RV overload.
  • This approach effectively addresses RV-induced LV compression, potentially improving overall cardiac performance.
  • Further studies are warranted to confirm long-term efficacy and expand indications.