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Which hearts are unsuitable for biventricular correction?

R H Anderson1, S Y Ho

  • 1Department of Paediatrics, Imperial College School of Medicine at National Heart and Lung Institute, London, England, UK.

The Annals of Thoracic Surgery
|September 2, 1998
PubMed
Summary
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Biventricular repair requires two functional ventricles. Morphologic assessment of ventricular size, septal alignment, and valve structure is crucial for determining suitability for this complex heart surgery.

Area of Science:

  • Congenital heart disease
  • Pediatric cardiology
  • Cardiac surgery

Background:

  • Biventricular repair necessitates two ventricles capable of supporting systemic and pulmonary circulation.
  • Assessing morphologic substrates is vital to identify potential contraindications for biventricular repair.

Purpose of the Study:

  • To evaluate morphologic mechanisms causing unbalanced ventricular mass.
  • To identify features contraindicating biventricular repair.

Main Methods:

  • Review of heart specimens.
  • Assessment of morphologic features leading to ventricular imbalance.

Main Results:

  • Univentricular or indeterminate ventricles often present with abnormal connections and atrioventricular valve arrangements.

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  • Rudimentary ventricles may be too small for adequate circulation support.
  • Mechanisms like straddling valves, septal defects, and hypoplasia can preclude biventricular repair.

    • Conclusions:

    • Ventricular imbalance results from ventricular size/morphology, septal alignment, and valve issues.
    • These morphologic factors significantly impact the decision-making process for biventricular repair.