title: One and one-half ventricle repair: results and concerns.
abstract: BACKGROUND
  The study was designed to assess the long-term results of one and one-half ventricular repair on systemic and pulmonary circulation, right ventricular growth and function, and the prevalence of arrhythmias.
  
  
  METHODS
  Eighty-four patients undergoing one and one-half ventricular repair between January 1990 and December 2003 were studied. Age was 4 to 504 months (mean, 47.9 +/- 57.3 months). Sixty-nine survivors underwent serial echocardiography, radionuclide studies, cardiac magnetic resonance imaging, and cardiac catheterization.
  
  
  RESULTS
  Operative and late mortality were 10.7% and 8%, respectively. Perioperative and postoperative supraventricular arrhythmias were observed in 14.3% and 15.9% of patients, respectively. Risk factors for supraventricular arrhythmias included systemic ventricular dysfunction, heterotaxy syndrome, and Ebstein's anomaly. Mean late postoperative superior vena caval pressure was 14.2 +/- 1.52 mm Hg and right atrial pressure was 6.6 +/- 0.74 mm Hg. At a median follow-up of 87 months, actuarial survival was 81.9% +/- 0.04%, and 89.8% were in New York Heart Association class I or II. Serial cine-magnetic resonance imaging demonstrated significant growth of tricuspid valve and right ventricular cavity in 45% of patients.
  
  
  CONCLUSIONS
  One and one-half ventricular repair can be performed with an acceptable risk. The operation maintains a low pressure in the inferior vena caval tributaries, and reverses the Fontan paradox. Patients with tripartite right ventricles demonstrated a tendency toward enlargement of the pulmonary ventricular chamber commensurable with somatic growth.
authors.affiliation: Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi, India. ujjwalchow@rediffmail.com
authors.forename: Ujjwal K
authors.initials: UK
authors.lastname: Chowdhury
authors.forename: Balram
authors.initials: B
authors.lastname: Airan
authors.forename: Sachin
authors.initials: S
authors.lastname: Talwar
authors.forename: Shyam Sunder
authors.initials: SS
authors.lastname: Kothari
authors.forename: Anita
authors.initials: A
authors.lastname: Saxena
authors.forename: Rajvir
authors.initials: R
authors.lastname: Singh
authors.forename: Ganapathy K
authors.initials: GK
authors.lastname: Subramaniam
authors.forename: Rajnish
authors.initials: R
authors.lastname: Juneja
authors.forename: Kizakke K
authors.initials: KK
authors.lastname: Pradeep
authors.forename: Siddhartha
authors.initials: S
authors.lastname: Sathia
authors.forename: Panangipalli
authors.initials: P
authors.lastname: Venugopal
mesh_terms: D000293:Adolescent; D000328:Adult; D006348:Cardiac Surgical Procedures / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D006352:Heart Ventricles / Q000002:abnormalities* / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology