From Fontan to Anatomical Repair 16 Years Later

Decision making for univentricular or anatomical repair remains challenging in children with borderline left ventricle. Unpredictable outcomes have led many caregivers to pursue a single-ventricle strategy. We describe 2 cases of patients with borderline left ventricle initially palliated with univentricular strategy followed by very late conversion to anatomical repair 4 and 16 years later. Anatomical conversion should be considered for these patients even many years later. During the first palliation stages, hemodynamic conditions preserving the potential for growth of the left ventricle should be maintained. (C) 2021 by The Society of Thoracic Surgeons

Automated summary

Decision making for children with borderline left ventricle remains challenging, but conversion to anatomical repair should be considered even many years later to preserve the potential for growth of the left ventricle.