Despite significant improvements in the management of Fontan circulation in patients
with single ventricle physiology, long-term outcomes continue to be suboptimal. Conversion
to biventricular circulation is increasingly gaining popularity, particularly in the
subset of patients who are not ideal Fontan candidates. Meticulous image-guided planning,
extensive preoperative discussions, and a team-based approach are required for successful
execution of complex biventricular conversion. A segmental approach to the anatomy
of the heart defect allows methodical planning of the technique of biventricular conversion.
Ventricular size and function continue to be the Achilles heel of successful biventricular
repair. Long-term studies comparing outcomes in patients converted to biventricular
circulation to those in patients with Fontan physiology are required to appropriately
tailor management approaches to an individual patient.
Keywords
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Conflicts of Interest: The authors report no conflict of interest.
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