Key result
Biventricular conversion is a potential alternative strategy for certain neonates with borderline left heart structures to avoid ultimate Fontan palliation.
Why the study?
Ongoing concerns with single-ventricle palliation morbidity and poor outcomes from primary biventricular strategies for neonates with borderline left heart structures have prompted interest in alternative conversion strategies.
Does biventricular conversion improve outcomes compared to single-ventricle palliation in patients with borderline left heart structures?
Does biventricular conversion improve outcomes compared to single-ventricle palliation in patients with borderline left heart structures?
This review highlights alternative strategies for achieving biventricular circulation in patients with borderline left heart structures to avoid the morbidity of single-ventricle palliation.
May support considering biventricular strategies in select borderline left heart cases; leaves open comparative outcome trials versus single-ventricle palliation.
Ongoing concerns with single-ventricle palliation morbidity and poor outcomes from primary biventricular strategies for neonates with borderline left heart structures have led some centers to attempt alternative strategies to obviate the need for ultimate Fontan palliation and limit the risk to the child during the vulnerable neonatal period. In certain patients who are traditionally palliated toward single-ventricle circulation, biventricular circulation is possible. This review aims to delineate the current knowledge regarding converting certain patients with borderline left heart structures from single-ventricle palliation toward biventricular circulation.
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Greenleaf et al. (2022) conducted a review in Hypoplastic left heart variants with borderline left heart structures. Biventricular conversion vs. Single-ventricle palliation was evaluated. Biventricular conversion is a potential alternative strategy for certain neonates with borderline left heart structures to avoid ultimate Fontan palliation.
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