Atrioventricular septal defects with severe left ventricular hypoplasia

Management of the left atrioventricular valve in 95 patients with atrioventricular septal defects and a common atrioventricular orifice—a ten year review

“…Patients with hypoplastic left ventricle are no longer considered candidates for biventricular repair when the diameter of the left atrioventricular valve is far below the acceptable range for weight. A Norwood type of procedure 7 or cardiac transplantation is currently considered instead.…”

“…Three patients, in whom the diameter of left atrioventricular orifice was only mildly reduced with regard to the normal size for the weight of the patient, had mild hypoplasia of the left ventricle which did not prevent repair. Patients with severe hypoplasia of both the left atrioventricular orifice and of the left ventricle, who are more recently considered candidates for univentricular repair, 7 were not included in this study. Left ventricular outflow tract obstruction 8 was present in 3 patients, due to accessory valvar tissue (2 cases) and abnormal location of the anterior papillary muscle of the left atrioventricular valve (1 case).…”

The angulation of the septal structures impacts ventricular imbalance in atrioventricular septal defects with a common atrioventricular junction

“…The valve guarding the common junction is usually committed equally to both ventricles through symmetrical bi-ventricular connections. [1][2][3] In a small proportion of patients, however, the junction is unequally shared between the ventricles, and the arrangement is then described in terms of ventricular imbalance. 4 Standard crosssectional echocardiography has traditionally been thought sufficient to provide pre-operative information for clinical decision-making with regard to the suitability for the creation of bi-ventricular circulations.…”

Editorial: Univentricular Heart

“…The introduction of the use of the end-to-side anastomosis of the transected main pulmonary artery to the ascending aorta (Damus–Kaye–Stansel), as source of systemic blood flow, facilitated the management of patients with “functionally” univentricular heart with obstruction to the systemic blood flow ( 6 ).…”