Staged Ventricular Septation of the Double-Inlet Ventricle: How-I-Do-It

Area of Science:

• Pediatric Cardiac Surgery
• Congenital Heart Disease
• Cardiovascular Surgery

Background:

• Double-inlet ventricle (DIV) is a complex congenital heart defect.
• Historically, ventricular septation for DIV had poor outcomes.
• Fontan palliation for DIV has known long-term complications.

Purpose of the Study:

• To summarize a staged septation approach for DIV.
• To evaluate patient selection, surgical techniques, and outcomes.
• To reconsider DIV septation as an alternative to Fontan palliation.

Main Methods:

• Review of a long-term patient series undergoing staged septation.
• Focus on patient selection criteria for biventricular repair.
• Detailed description of surgical techniques and perioperative management.

Main Results:

• Presents long-term data from a center revisiting DIV septation.
• Highlights considerations for timing of interventions.
• Discusses outcomes in the context of Fontan palliation sequelae.

Conclusions:

• Staged ventricular septation for DIV warrants reconsideration.
• Suitable anatomical candidates may benefit from this approach.
• Offers an alternative to mitigate Fontan palliation complications.