Current status of the septation procedure for univentricular heart

The current status of the septation procedure for univentricular heart was assessed by analyzing the outcomes of 45 procedures done from 1973 through June of 1978. The hospital mortality was 21 (47%) of 45 patients, and eight (18%) patients died during follow-up. Of the 16 survivors, 12 have a fair-to-good surgical result and four are doing poorly. Only two factors were significantly related to increased survival: no history of congestive failure and no previous palliative procedure. Multivariate analysis revealed a small subgroup of 11 patients with a survival rate of 82%. These patients had a subaortic chamber to the left, no previous congestive failure, no previous palliation, and no profound polycythemia, and they were between 5 and 15 years of age at operation. Current practice now employs the Fontan procedure for patients with univentricular heart and low pulmonary artery pressure and resistance. However, nearly half of the patients with univentricular heart will not qualify for a Fontan procedure. For a selected group of these patients, septation must be considered because of the poor long-term outlook for patients with univentricular heart who do not undergo operation.