One and a half ventricular repair as an alternative for hypoplastic right ventricle

Abstract

Operação de um ventrículo e meio como uma alternativa para o ventrículo direito hipoplásicoOne and a half ventricular repair as an alternative for hypoplastic right ventricle Endereço Conclusões: O tratamento cirúrgico de cardiopatias congênita, na presença de um ventrículo direito hipoplásico, por meio da operação de um ventrículo e meio, tem menor risco cirúrgico que a correção biventricular, mantendo o átrio direito com baixa pressão, fluxo sanguíneo pulmonar pulsátil e melhora da saturação sistêmica de oxigênio. Os resultados de curto e médio prazo são satisfatórios; porém será necessário um maior tempo de seguimento para provar a eficácia desta abordagem cirúrgica a longo prazo. Descritores 467MALUF, MA ET AL -Operação de um ventrículo e meio como uma alternativa para o ventrículo direito hipoplásico Bras Cir Cardiovasc 2010; 25(4): 466-473 Conclusions: Surgical treatment of congenital cardiac anomalies in the presence of a hypoplastic right ventricle by means of one and a half ventricle repair has the advantages of reducing the surgical risk of biventricular repair compared to the Fontan circulation; it maintains a low right atrium pressure, a pulsatile pulmonary blood flow and improves the systemic oxygen saturation with short and medium-term promising results. Longer follow-up is needed to prove the efficacy of such a repair in the long term. RevDescriptors: Heart defects, congenital/surgery. Heart valve prosthesis implantation, methods. Child. Pulmonary atresia. Ebstein anomaly.

A survey of recently published cardiovascular, hematological and pneumological original articles in the Brazilian scientific press

“…Maluf et al21 studied patients with complex congenital heart disease, characterized by right ventricle hypoplasia, had a palliative surgical option with one and a half ventricular repair and claim that surgical treatment of the congenital cardiac anomalies in the presence of a hypoplastic right ventricle by means of one and a half ventricle repair has the advantages of reducing the surgical risk of biventricular repair compared to the Fontan circulation. da Rocha et al22 assessed the morbidity and mortality after Jatene's operation using lactate as the main marker and claim that morbidity and mortality can be assessed with the serum lactate levels, suggesting increased values in the third hour is suggestive of a worse prognosis.…”

Uhl’s anomaly: A one and a half ventricular repair in a patient presenting with cardiac arrest

“…We report the case of a previously active adolescent male presenting with cardiac arrest who underwent successful bidirectional cavopulmonary anastomosis (“Glenn” anastomosis) with right ventricular free wall plication. A one and a half ventricular repair is employed when there is a normally functioning left ventricle (normal size and function) along with a dysfunctional right ventricle, inadequate to handle the entire cardiac output, but considered of sufficient size to handle one half to two thirds of the cardiac output [10]. Given the patient’s cardiac imaging, we determined that a one and a half ventricular repair approach, coupled with ICD placement to address arrhythmia risk, would be the best option for palliation of this exceedingly rare defect.…”

Perioperative and Anesthetic Considerations in Pulmonary Atresia With Intact Ventricular Septum

“…If tolerated, a 1.5-ventricle palliation may be preferable to a Fontan circulation. 27,28,29 Partially incorporating a hypoplastic RV in the pulmonary circulation can, in theory, restore ventriculo-arterial coupling by producing a stepdown in pressure in the inferior vena cava and a step-up in PA pressures, thereby avoiding the caval hypertension and PA hypotension that exists in the Fontan circulation. Those patients who do not tolerate closure of the ASD proceed to Fontan single-ventricle palliation.…”