Univentricular heart with systemic outflow obstruction: Palliation by primary Damus procedure

Outcome of patients with double-inlet left ventricle or tricuspid atresia with transposed great arteries

“…Double-inlet left ventricle (DILV) and tricuspid atresia with transposed great arteries (TA-TGA) are two forms of a single left ventricle (LV) at risk of developing systemic outflow obstruction and poor outcomes (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11). Patients with these types of congenital heart disease frequently have an associated aortic arch anomaly and may develop pulmonary vascular disease due to excessive pulmonary blood flow (5,6).…”

Outcome of the Norwood procedure in the setting of transposition of the great arteries and functional single left ventricle☆

“…The difficulty in enlarging the VSD at young age is also reflected by an early mortality of nearly 60% in patients less than 1-year old [19]. Some authors, including ourselves, believe that exposure of the subaortic area can be very difficult in neonates and an additional patch enlargement of the rudimentary right ventricle might be necessary [14,15]. Furthermore, in cases of obstruction due to abnormal attachments of the atrioventricular valve, VSD enlargement may not be effective [14].…”

“…These and other associated anomalies are summarised in Table 2 The surgical technique has been described elsewhere [15,17] and is summarised below. Deep hypothermia to 18 8C with periods of circulatory arrest was employed for all repairs.…”

“…This potentially adds to the complexity of the initial procedure and may expose patients to a higher operative risk [15].…”

“…We have adopted the concept of creating an unobstructed outflow by mean of a Norwood type of procedure [12,15,16] as an alternative approach. This potentially adds to the complexity of the initial procedure and may expose patients to a higher operative risk [15].…”