One and one-half ventricle repair: results and concerns.
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.
Chowdhury
Ujjwal K
UK
Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi, India. ujjwalchow@rediffmail.com
Airan
Balram
B
Talwar
Sachin
S
Kothari
Shyam Sunder
SS
Saxena
Anita
A
Singh
Rajvir
R
Subramaniam
Ganapathy K
GK
Juneja
Rajnish
R
Pradeep
Kizakke K
KK
Sathia
Siddhartha
S
Venugopal
Panangipalli
P
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