Division of Cardiovascular and Thoracic Surgery, Duke University Medical Center, 2301 Erwin Road, DUMC 3474, Durham, NC, 27710, USA.
Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Duke University Medical Center, Durham, NC, USA.
Curr Cardiol Rep. 2020 Aug 8;22(10):115. doi: 10.1007/s11886-020-01363-5.
The development of biventricular repair and conversion pathways for patients with borderline hypoplastic heart disease represents an area of recent inquiry and innovation. This review summarizes emerging techniques and novel treatment algorithms for borderline hypoplastic heart disease with a focus on surgical advances within the last 10 years.
Many patients with borderline hypoplastic heart disease are amenable to primary biventricular repair, or biventricular conversion following single-ventricle palliation coupled with ventricular rehabilitation strategies. New insights into the potential for growth and recovery of borderline ventricles have been uncovered. However, questions remain regarding optimal patient selection and the long-term outcomes of select patient groups treated with single-ventricle palliation versus biventricular repair/conversion or transplantation. Efforts to direct a greater proportion of borderline hypoplastic heart patients towards a biventricular circulation are accelerating and represent important avenues for progress and future research in the field of congenital heart disease.
边缘性发育不良心脏疾病患者的双心室修复和转换途径的发展代表了近期研究和创新的一个领域。本综述总结了边缘性发育不良心脏疾病的新兴技术和新的治疗方案,重点介绍了过去 10 年的手术进展。
许多边缘性发育不良心脏疾病患者适合进行双心室修复,或在单心室姑息治疗后进行双心室转换,同时结合心室康复策略。人们对边缘性心室的生长和恢复潜力有了新的认识。然而,关于最佳患者选择以及接受单心室姑息治疗与双心室修复/转换或移植治疗的特定患者群体的长期结果,仍存在疑问。努力使更多的边缘性发育不良心脏疾病患者转向双心室循环正在加速,并代表着先天性心脏病领域取得进展和未来研究的重要途径。