[Exclusion of venous ventricle. Evolution and challenges].

The history and evolution of the cardiovascular surgery and pediatric cardiology is fascinating. For centuries many erroneous galenic concepts about cardiovascular anatomy and physiology were sustained by physicians. At the end of the XIX century and during the XX century, the progress in science allowed for a more appropriate understanding of the anatomophysiology of the cardiovascular system, promoting the concept of dispensability of half of the heart. This concept of right ventricle dispensability has subsisted, teaching us lessons that have led to a bear understanding of the hemodinamic behavior of many cardiac congenital malformations. The cavopulmonar total bypass or Fontan procedure with its modifications is an example of this knowledge. In the present article we make a brief historical review of the concept of right ventricle dispensability, and a brief analysis of the learned lessons provided by many authors and our own experience, without forgetting that we still have a long way to fully understand the pulmonary vasculature behavior and the univentricular physiology.