SURGICAL MANAGEMENT OF SINGLE VENTRICLE

Abstract

Single ventricle anomalies are considered one of the most challenging of congenital heart malformations, not only in it's management but also in it's description and classification. It include all cases in which the two atria are connected to only one ventricle that is well developed and dominant. This results in arrangement of systemic and pulmonary blood flow in a parallel fashion rather than in series as in normal hearts, resulting in a drastically

altered natural history culminating to death of the patient any where from the first days to the second decade of life.

Single ventricle anomalies were usually described by either van Praagh or Anderson classifications but now a new descriptive language was coined by the STS congenital heart surgery database committee and representatives from the European Association for cardiothoracic surgery for better description and classification.

Single ventricle affects approximately 3% of infants born with congenital heart disease and it's clinical picture is determined mainly by the anatomy and associated lesions. In the presence of pulmonary outflow obstruction, the manifestation will be in the form of severe cyanosis without heart failure and if the pulmonary outflow is unobstructed the manifestation will be in the form of marked heart failure with minimal or no cyanosis.