Univentricular Heart

Introduction: The univentricular heart refers to a pathophysiological concept in which a single functional ventricle provides both pulmonary and systemic aortic flow in parallel. The aim of this study was to conduct an epidemiological study of the univentricular heart, to study the circumstances of discovery, to analyze the problems posed by the diagnostic and therapeutic management of these patients in our Moroccan context by evaluating the diagnostic role of Doppler echocardiography and finally evaluating the evolution of these operated children. Methods: This was a retrospective study in the cardiovascular surgery department of CHU IBN ROCHD in Casablanca, over a period of 3 years from January 2017 to December 2019 involving 4 patients, whose age varies between 6 months and 7 years. Results: The sex ratio was 1. The average age of the patients was 8 months and 6 years respectively for the pulmonary artery cerclage and for the Fontan treatment. Consanguinity, diabetes, hypertension and advanced maternal age were the main antecedents. Several circumstances of discovery have been highlighted, the most common are: perioral cyanosis in 3 patients, growth restriction with eating difficulties in 3 patients and dyspnea in 2 others. Pulmonary arterial hypertension and pulmonary stenosis were present in 50% of the patients. The diagnosis was made by echocardiography and the most common anatomical form of the single ventricle was tricuspid atresia in 2 patients. All patients were operated: 2 received pulmonary artery cerclage and 2 others received Fontan treatment, 1 of them had primary pulmonary artery cerclage in his history. In our study, no deaths were reported. Postoperative complications were dominated by atelectasis, infectious complications, bleeding and pleuro-pericardial effusion. The short and medium-term postoperative evolution was favorable for all our patients with weight gain, symptom reduction and improvement in O2 saturation.