Unbalanced atrioventricular septal defect (uAVSD) is a challenging lesion with suboptimal
outcomes in the current era. Severe forms of uAVSD mandate univentricular repair with
well-documented outcomes. Determining the feasibility of biventricular repair (BVR)
in patients with moderate forms of uAVSD is difficult. Ventricular hypoplasia has
traditionally formed the cornerstone of defining uAVSD. However, malalignment of the
atrioventricular junction and related derangements of the anatomy and physiology of
the atrioventricular inflow play a central role in establishing and sustaining a biventricular
end state. Atrioventricular valve index, left ventricular inflow index, and right
ventricle/left ventricle inflow angle are important recently described measures of
inflow physiology. Additional patient anatomic and physiologic factors that impact
BVR feasibility undoubtedly exist. A recently launched Congenital Heart Surgeons Society
prospective inception cohort study will address these and other issues that impair
our ability to predict BVR feasibility in uAVSD.
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Article info
Footnotes
Supported in part by a grant from the Saving Tiny Hearts Society.
Dr Overman reports receiving grant support from the Saving Tiny Hearts Society. Drs Dummers, Gremmels, and Moga have not commercial interests to disclose.
Surgical results for functional univentricular heart with total anomalous pulmonary venous connection over a 25-year experience.
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
