Nicholas D Andersen1,2, Jacob C Scherba3,4, Joseph W Turek3,4. 1. Division of Cardiovascular and Thoracic Surgery, Duke University Medical Center, 2301 Erwin Road, DUMC 3474, Durham, NC, 27710, USA. Nicholas.Andersen@Duke.edu. 2. Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Duke University Medical Center, Durham, NC, USA. Nicholas.Andersen@Duke.edu. 3. Division of Cardiovascular and Thoracic Surgery, Duke University Medical Center, 2301 Erwin Road, DUMC 3474, Durham, NC, 27710, USA. 4. Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Duke University Medical Center, Durham, NC, USA.
Abstract
PURPOSE OF REVIEW: The development of biventricular repair and conversion pathways for patients with borderline hypoplastic heart disease represents an area of recent inquiry and innovation. This review summarizes emerging techniques and novel treatment algorithms for borderline hypoplastic heart disease with a focus on surgical advances within the last 10 years. RECENT FINDINGS: Many patients with borderline hypoplastic heart disease are amenable to primary biventricular repair, or biventricular conversion following single-ventricle palliation coupled with ventricular rehabilitation strategies. New insights into the potential for growth and recovery of borderline ventricles have been uncovered. However, questions remain regarding optimal patient selection and the long-term outcomes of select patient groups treated with single-ventricle palliation versus biventricular repair/conversion or transplantation. Efforts to direct a greater proportion of borderline hypoplastic heart patients towards a biventricular circulation are accelerating and represent important avenues for progress and future research in the field of congenital heart disease.
PURPOSE OF REVIEW: The development of biventricular repair and conversion pathways for patients with borderline hypoplastic heart disease represents an area of recent inquiry and innovation. This review summarizes emerging techniques and novel treatment algorithms for borderline hypoplastic heart disease with a focus on surgical advances within the last 10 years. RECENT FINDINGS: Many patients with borderline hypoplastic heart disease are amenable to primary biventricular repair, or biventricular conversion following single-ventricle palliation coupled with ventricular rehabilitation strategies. New insights into the potential for growth and recovery of borderline ventricles have been uncovered. However, questions remain regarding optimal patient selection and the long-term outcomes of select patient groups treated with single-ventricle palliation versus biventricular repair/conversion or transplantation. Efforts to direct a greater proportion of borderline hypoplastic heart patients towards a biventricular circulation are accelerating and represent important avenues for progress and future research in the field of congenital heart disease.
Authors: Neel K Prabhu; Douglas M Overbey; Arya M Iranmanesh; Michael J Campbell; Nicholas D Andersen; Joseph W Turek Journal: JTCVS Tech Date: 2022-03-31