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Published in: Indian Journal of Thoracic and Cardiovascular Surgery 3/2018

01-07-2018 | Review Article

One and half ventricle repair: rationale, indications, and results

Authors: Sachin Talwar, Bharat Siddharth, Shiv Kumar Choudhary, Balram Airan

Published in: Indian Journal of Thoracic and Cardiovascular Surgery | Issue 3/2018

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Abstract

Surgical strategies in patients with functionally or anatomically borderline right ventricles include a high-risk biventricular repair, a Fontan procedure, or a one and half ventricle repair (also referred to as the partial biventricular repair). One and half ventricle repair (1.5VR) circumvents the high early mortality of a biventricular repair and also the late morbidity of the Fontan. The two most common indications for a 1.5VR are a small pulmonary ventricle and a dilated poorly functioning pulmonary ventricle. Extension of 1.5VR to patients undergoing anatomical repair for congenitally corrected transposition of great arteries, straddling tricuspid valves, and severe Ebstein’s anomaly has facilitated biventricular repair with decreased mortality. We reviewed the relevant literature on this subject in detail and describe its rationale, indications and its early and late results.
Literature
1.
go back to reference Billingsley AM, Laks H, Boyce SW, George B, Santulli T, Williams RG. Definitive repair in patients with pulmonary atresia and intact ventricular septum. J Thorac Cardiovasc Surg. 1989; 97:746–54. Billingsley AM, Laks H, Boyce SW, George B, Santulli T, Williams RG. Definitive repair in patients with pulmonary atresia and intact ventricular septum. J Thorac Cardiovasc Surg. 1989; 97:746–54.
3.
go back to reference Muster AJ, Zales VR, Ilbawi MN, Backer CL, Duffy CE, Mavroudis C. Biventricular repair of hypoplastic right ventricle assisted by pulsatile bidirectional cavopulmonary anastomosis. J Thorac Cardiovasc Surg. 1993;105:112–9. Muster AJ, Zales VR, Ilbawi MN, Backer CL, Duffy CE, Mavroudis C. Biventricular repair of hypoplastic right ventricle assisted by pulsatile bidirectional cavopulmonary anastomosis. J Thorac Cardiovasc Surg. 1993;105:112–9.
4.
go back to reference Reddy VM, McElhinney DB, Silverman NH, Marianeschi SM, Hanley FL. Partial biventricular repair for complex congenital heart defects: An intermediate option for complicated anatomy or functionally borderline right complex heart. J Thorac Cardiovasc Surg. 1998;116:21–7. https://doi.org/10.1016/S0022-5223(98)70238-7. Reddy VM, McElhinney DB, Silverman NH, Marianeschi SM, Hanley FL. Partial biventricular repair for complex congenital heart defects: An intermediate option for complicated anatomy or functionally borderline right complex heart. J Thorac Cardiovasc Surg. 1998;116:21–7. https://​doi.​org/​10.​1016/​S0022-5223(98)70238-7.
5.
go back to reference Uribe S, Bachler P, Valverde I, et al. Hemodynamic assessment in patients with one-and-a- half ventricle repair revealed by Four-dimensional flow magnetic resonance imaging. Pediatr Cardiol. 2012;34:447–51. Uribe S, Bachler P, Valverde I, et al. Hemodynamic assessment in patients with one-and-a- half ventricle repair revealed by Four-dimensional flow magnetic resonance imaging. Pediatr Cardiol. 2012;34:447–51.
17.
go back to reference Milliken JC, Laks H, Hellenbrand W, George B, Chin A, Williams RG. Early and late results in the treatment of patients with pulmonary atresia and intact ventricular septum. Circulation. 1985; 72: II-61-II-69. Milliken JC, Laks H, Hellenbrand W, George B, Chin A, Williams RG. Early and late results in the treatment of patients with pulmonary atresia and intact ventricular septum. Circulation. 1985; 72: II-61-II-69.
19.
go back to reference Reddy VM, Liddicoat JR, McElhinney DB, Brook MM, van Son JM, Hanley FL. Biventricular repair of lesions with straddling tricuspid valves using techniques of chordal translocation and realignment. Cardiol Young. 1997;7:147–52. Reddy VM, Liddicoat JR, McElhinney DB, Brook MM, van Son JM, Hanley FL. Biventricular repair of lesions with straddling tricuspid valves using techniques of chordal translocation and realignment. Cardiol Young. 1997;7:147–52.
21.
go back to reference Ilbawi MN, DeLeon SY, Backer CL, et al. An alternative approach to the surgical management of physiologically corrected transposition with ventricular septal defect and pulmonary stenosis or atresia. J Thorac Cardiovasc Surg. 1990;100:410–5. Ilbawi MN, DeLeon SY, Backer CL, et al. An alternative approach to the surgical management of physiologically corrected transposition with ventricular septal defect and pulmonary stenosis or atresia. J Thorac Cardiovasc Surg. 1990;100:410–5.
23.
go back to reference Mavroudis C, Backer C. Physiologic versus anatomic repair of congenitally corrected transposition of great arteries. Semin Thorac Cardiovasc Surg Ped Card Surg Annu. 2003;6:16–26. Mavroudis C, Backer C. Physiologic versus anatomic repair of congenitally corrected transposition of great arteries. Semin Thorac Cardiovasc Surg Ped Card Surg Annu. 2003;6:16–26.
26.
go back to reference Gentles TL, Keane JF, Jonas RA, Marx GE, Mayer JE Jr. Surgical alternatives to the Fontan procedure incorporating a hypoplastic right ventricle. Circulation. 1994;90:II1–6. Gentles TL, Keane JF, Jonas RA, Marx GE, Mayer JE Jr. Surgical alternatives to the Fontan procedure incorporating a hypoplastic right ventricle. Circulation. 1994;90:II1–6.
28.
go back to reference Frommelt MA, Frommelt PC, Berger S, et al. Does an additional source of pulmonary blood flow alter outcome after a bidirectional cavopulmonary shunt? Circulation. 1995;92:II240-4. Frommelt MA, Frommelt PC, Berger S, et al. Does an additional source of pulmonary blood flow alter outcome after a bidirectional cavopulmonary shunt? Circulation. 1995;92:II240-4.
31.
go back to reference Numata S, Uemura H, Yagihara T, Kagisaki K, Takahashi M, Ohuchi H. Long-term functional results of the one and one half ventricular repair for the spectrum of patients with pulmonary atresia/stenosis with intact ventricular septum. Eur J Cardiothorac Surg. 2003;24:516–520. https://doi.org/10.1016/S1010-7940(03)00378-6. Numata S, Uemura H, Yagihara T, Kagisaki K, Takahashi M, Ohuchi H. Long-term functional results of the one and one half ventricular repair for the spectrum of patients with pulmonary atresia/stenosis with intact ventricular septum. Eur J Cardiothorac Surg. 2003;24:516–520. https://​doi.​org/​10.​1016/​S1010-7940(03)00378-6.
Metadata
Title
One and half ventricle repair: rationale, indications, and results
Authors
Sachin Talwar
Bharat Siddharth
Shiv Kumar Choudhary
Balram Airan
Publication date
01-07-2018
Publisher
Springer Singapore
Published in
Indian Journal of Thoracic and Cardiovascular Surgery / Issue 3/2018
Print ISSN: 0970-9134
Electronic ISSN: 0973-7723
DOI
https://doi.org/10.1007/s12055-017-0628-5

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