title: A practical approach to 1 1/2 ventricle repairs.
abstract: BACKGROUND
  Perioperative and long-term problems associated with the Fontan circulation are substantial. There has been an exploration of extending the limits of a biventricular ventricular repair by using a superior vena cava-to-pulmonary artery anastomosis. This type of repair is known as a 1 1/2 ventricle repair.
  
  
  METHODS
  Patients having defects of the pulmonary ventricle in size or function have undergone 1 1/2 ventricle repairs with or without creation of an atrial septal defect. Repairs with tricuspid z values as small as -10 and predicted pulmonary ventricular volumes as low as 30% have been reported. The 1 1/2 ventricle repair technique has also been used in special situations associated with an arterial switch or double switch procedure.
  
  
  RESULTS
  Mortality has ranged from 0% to 12%. Complications have included persistent elevation of superior vena cava pressure, intermittent periorbital edema, and 1 superior vena caval aneurysm requiring takedown. There appears to be an increased risk of perioperative pleural effusions and chylothorax. Protein-losing enteropathy and chronic atrial arrhythmias have not been present.
  
  
  CONCLUSIONS
  Successful 1 1/2 ventricle repairs have been reported for morphologically small or poorly functioning pulmonary ventricles and special situations. Intermediate-term follow-up is favorable when compared with reported outcomes for the Fontan circulation.
authors.affiliation: Division of Cardiac Surgery, The Hospital for Sick Children, University of Toronto, Ont, Canada.
authors.forename: G S
authors.initials: GS
authors.lastname: Van Arsdell
authors.forename: W G
authors.initials: WG
authors.lastname: Williams
authors.forename: R M
authors.initials: RM
authors.lastname: Freedom
mesh_terms: D000714:Anastomosis, Surgical; D006330:Heart Defects, Congenital / Q000601:surgery; D006352:Heart Ventricles / Q000601:surgery*; D006801:Humans; D011651:Pulmonary Artery / Q000601:surgery*; D014683:Vena Cava, Superior / Q000601:surgery*