Staged repair of borderline hypoplastic heart disease with early biventricular conversion.
| Title: | Staged repair of borderline hypoplastic heart disease with early biventricular conversion. |
|---|---|
| Authors: | Andersen ND; Department of Cardiothoracic Surgery, University of Texas Southwestern and Children's Health, Dallas, Tex.; Overbey DM; Department of Surgery, Duke Children's Pediatric & Congenital Heart Center, Duke Children's Hospital, Durham, NC.; Prabhu NK; Department of Surgery, Duke Children's Pediatric & Congenital Heart Center, Duke Children's Hospital, Durham, NC.; McCrary AW; Department of Pediatrics, Duke Children's Pediatric & Congenital Heart Center, Duke Children's Hospital, Durham, NC.; Sherwin JI; Department of Pediatrics, Duke Children's Pediatric & Congenital Heart Center, Duke Children's Hospital, Durham, NC.; Allareddy V; Department of Pediatrics, Duke Children's Pediatric & Congenital Heart Center, Duke Children's Hospital, Durham, NC.; Turek JW; Department of Surgery, Duke Children's Pediatric & Congenital Heart Center, Duke Children's Hospital, Durham, NC. |
| Source: | JTCVS techniques [JTCVS Tech] 2024 Feb 19; Vol. 24, pp. 150-163. Date of Electronic Publication: 2024 Feb 19 (Print Publication: 2024). |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Elsevier Inc Country of Publication: United States NLM ID: 101768546 Publication Model: eCollection Cited Medium: Internet ISSN: 2666-2507 (Electronic) Linking ISSN: 26662507 NLM ISO Abbreviation: JTCVS Tech Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: [New York] : Elsevier Inc., [2020]- |
| Abstract: | Objective: In select patients with borderline ventricular hypoplasia, we adopted a strategy of initial single-ventricle palliation followed by staged or direct biventricular conversion by 2 years of age.; Methods: Between 2018 and 2023, 14 newborns with borderline hypoplastic heart disease deemed high risk for primary biventricular repair underwent palliative procedures as a neonate/infant, followed by staged or direct biventricular conversion.; Results: Of the 14 patients, 6 had borderline left ventricles and 8 had borderline right ventricles. Index neonatal operations were performed in 12 patients and included the Norwood operation (n = 5), pulmonary artery band (n = 3), ductal stent (n = 3), and hybrid Norwood (n = 1). Five patients underwent direct biventricular conversion, and the remaining 9 patients underwent staged ventricular recruitment operations at a mean age of 6 months (range, 3-11 months). Ventricular recruitment operations included atrial septation with or without ventricular rehabilitation, atrioventricular valve repair, or outflow tract operations. At a mean duration of 8 months (range, 4-10 months) after ventricular recruitment, there was a significant increase in chamber volume, aortic valve, and mitral valve size in patients with borderline left ventricles, and a normalization of the right ventricle:left ventricle end-diastolic volume ratio in patients with borderline right ventricles. To date, 13 of 14 patients have undergone successful biventricular conversion at a mean age of 16 months (range, 4-31 months).; Conclusions: In select newborns with borderline hypoplastic heart disease, single-ventricle palliation followed by staged or direct biventricular conversion may increase infant survival while allowing for early attainment of a biventricular circulation.; (© 2024 The Author(s).) |
| Competing Interests: | The authors reported no conflicts of interest. The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling or reviewing manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest. |
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| Contributed Indexing: | Keywords: atrioventricular septal defect; biventricular conversion; borderline ventricle; hypoplastic left heart syndrome; ventricular recruitment |
| Entry Date(s): | Date Created: 20240605 Latest Revision: 20240607 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC11145415 |
| DOI: | 10.1016/j.xjtc.2024.02.006 |
| PMID: | 38835569 |
| Database: | MEDLINE |
Journal Article