[Palliation for univentricular hearts].

Abstract

Palliative operations for 44 univentricular hearts have been evaluated as bridges to Fontan operation. Pulmonary artery banding was the first palliation for 13 patients (pts) with high pulmonary blood flow (HPF), and systemic to pulmonary shunt was that for 27 pts with low pulmonary blood flow (LPF). 8 of the 13 with HPF required additional operation of Bidirectional Glenn (BDG) and Fontan operation. 5 pts underwent Fontan operation and 8 (62%) were candidate of Fontan operation. On the other hand, 9 of the 27 died of low cardiac output, dehydration or increased atrioventricular regurgitation. 17 survived the first palliation had additional procedures including Blalock-Taussig shunt, BDG or Fontan operation. 7 had Fontan operation, and 10 were candidate for Fontan operation. Atrioventricular valvular regurgitation increased after systemic to pulmonary shunt compared to BDG (p < 0.01). These results suggested that BDG should be performed before A-V valvular regurgitation increased and be a good bridge for Fontan operation.