Biventricular repair

When a child is born with a borderline (smalght or left ventricle, it means that one of the heart’s two lower chambers (ventricles) isn’t large enough or strong enough to function normally. Children with these defects can be addressed in different ways.  Some of these patients need a series of open heart surgeries,an initial surgery at birth to create blood flow to both the body and the lungs, and later Glenn and Fontan procedures. This is referred to as “the single ventricle pathway” and performed because the second small ventricle is not large enough to pump the needed blood to support the body’s need.

 

Other patients with one borderline (small) right or left ventricle make be addressed differently.  If both ventricles are believed to be big enough to each work alone, surgeons will consider a complex biventricular repair initially or a biventricular conversion after the initial newborn surgery.  This means the patient will have end up with two ventricles and two separate circulations, just like a normal heart.

 

The board-certified and fellowship-trained specialists at Norton Children’s Heart Institute are able to determine when a biventricular repair or biventricular conversion is appropriate for your child.  When not appropriate, they will be able to discuss and offer the alternative open heart surgeries most appropriate to treat your child’s congenital heart defect.

What is a biventricular repair?

Types of biventricular repairs include:

  • Biventricular repair:The Norton Children’s Heart Institute surgeons are able to create two working ventricles during one open heart procedure. This procedure is Many children can have a complete repair soon after birth instead of needing multiple surgeries.
  • Biventricular conversion: This surgery is for patients who had a previous palliative repair done in the newborn period and possibly after a second procedure such as the Glenn procedure. This procedure refers to a “conversion” from single ventricle physiology where patients have mixing of blood and lower saturations to a two ventricle physiology where the blood going to the lungs and body are separated.  It converts the heart to a heart with two pumping ventricles, and likewise two different circulations.  Patients will generally then have normal oxygen saturations.
  • Staged ventricular recruitment: This is a series of procedures used when a child’s ventricle is too small for biventricular repair or biventricular conversion. The smaller ventricle may need to be “recruited,” or grown, to make a complete biventricular repair possible in the future.

Biventricular repair complications and after-care

Most children who have a biventricular repair or conversion procedure do very well. The long-term outlook for these children continues to improve. They often have more stamina, a better quality of life and fewer long-term complications than children who undergo the series of operations associated with the single ventricle repairs.

 

Your child will need lifelong follow-up care with a cardiologist to watch for possible complications.

Why choose Norton Children’s Heart Institute

No other congenital heart surgery program in Kentucky, Ohio or Southern Indiana is ranked higher by the Society of Thoracic Surgeons than the Norton Children’s Pediatric Cardiothoracic Surgery Program.

  • Norton Children’s Hospital has been a pioneer in pediatric cardiothoracic surgery, performing Kentucky’s first pediatric heart transplant in 1986 and becoming the second site in the United States to perform an infant heart transplant.
  • Our board-certified and fellowship-trained pediatric cardiovascular surgeons are leaders in the field as clinicians and researchers.
  • More than 5,000 children a year visit Norton Children’s Heart Institute, affiliated with the University of Louisville, for advanced heart care.
  • Norton Children’s Heart Institute successfully performs more than 17,500 procedures a year.
  • The Society of Thoracic Surgeons ranked Norton Children’s Heart Institute among the best in the region after studying years of our patients’ outcomes and our ability to handle a range of pediatric heart conditions, including the most severe.
  • Norton Children’s Heart Institute has satellite outpatient centers in Bowling Green, Frankfort, Owensboro and Paducah; 28 tele-echocardiography locations in Kentucky and Southern Indiana; and six fetal echocardiography locations across Kentucky.
  • The American Board of Thoracic Surgery has certified the cardiothoracic surgeons at Norton Children’s Hospital with subspecialty certification in congenital heart surgery.
  • The Jennifer Lawrence Cardiac Intensive Care Unit is under construction to give our patients the most advanced cardiac intensive care unit available.
  • Our multidisciplinary approach to pediatric heart surgery brings together our specialists in cardiothoracic surgery, cardiology, anesthesiology, cardiac critical care and other areas to create a complete care plan tailored for your child.
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Norton Children’s Heart Institute

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