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Related Experiment Videos

A practical approach to 1 1/2 ventricle repairs

G S Van Arsdell1, W G Williams, R M Freedom

  • 1Division of Cardiac Surgery, The Hospital for Sick Children, University of Toronto, Ont, Canada.

The Annals of Thoracic Surgery
|September 2, 1998
PubMed
Summary

The 1 1/2 ventricle repair offers a promising alternative to the Fontan circulation for complex heart defects. This surgical approach shows favorable intermediate-term outcomes, despite potential complications like pleural effusions.

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Area of Science:

  • Pediatric Cardiac Surgery
  • Congenital Heart Disease Repair

Background:

  • Fontan circulation poses significant perioperative and long-term challenges.
  • The 1 1/2 ventricle repair, utilizing a superior vena cava-to-pulmonary artery anastomosis, is explored as an alternative.
  • This technique aims to extend the limits of biventricular repair.

Purpose of the Study:

  • To evaluate the efficacy and outcomes of the 1 1/2 ventricle repair.
  • To assess its applicability in patients with pulmonary ventricle size or function defects.
  • To compare results with established Fontan circulation outcomes.

Main Methods:

  • Performing 1 1/2 ventricle repairs with or without atrial septal defect creation.
  • Applying the technique in cases with small tricuspid z values (as low as -10) and low predicted pulmonary ventricular volumes (as low as 30%).

Related Experiment Videos

  • Utilizing the 1 1/2 ventricle repair in conjunction with arterial switch or double switch procedures.

    • Main Results:

    • Reported mortality rates range from 0% to 12%.
    • Complications observed include elevated superior vena cava pressure, periorbital edema, and superior vena caval aneurysm.
    • Increased risks of perioperative pleural effusions and chylothorax were noted, while protein-losing enteropathy and chronic atrial arrhythmias were absent.

    Conclusions:

    • The 1 1/2 ventricle repair is successfully applied in morphologically small or poorly functioning pulmonary ventricles and special surgical situations.
    • Intermediate-term follow-up demonstrates favorable outcomes compared to the Fontan circulation.
    • This approach represents a viable option for complex congenital heart disease.