Najm Hani K, Oh Nicholas A
Department of Pediatric & Congenital Heart Surgery, Heart, Vascular, and Thoracic Institute Cleveland Clinic Foundation, Cleveland, OH, USA.
Department of Thoracic and Cardiovascular Surgery, Heart, Vascular, and Thoracic Institute, 2569Cleveland Clinic Foundation, Cleveland, OH, USA.
World J Pediatr Congenit Heart Surg. 2022 Sep;13(5):650-654. doi: 10.1177/21501351221116773.
Hypoplastic left heart complex (HLHC) constitutes a spectrum of left ventricular hypoplasia and valvar disease and can be associated with increased morbidity and mortality. Traditionally, management of these lesions involves single ventricle palliation (SVP). However, the SVP may be associated with substantial long-term consequences related to its physiology. Alternative management strategies have been employed to achieve biventricular circulation. We have proposed a novel technique, termed the "ventricular switch" procedure, in which the hypoplastic or unroutable left ventricle can be harnessed to function as the subpulmonic ventricle, and the right ventricle functions as the systemic ventricle. Herein, we describe our rationale for considering biventricular circulation and the ventricular switch procedure in HLHC and in other complex lesions.
左心发育不全综合征（HLHC）包括一系列左心室发育不全和瓣膜疾病，可伴有发病率和死亡率的增加。传统上，这些病变的治疗涉及单心室姑息治疗（SVP）。然而，SVP可能因其生理学特性而带来严重的长期后果。已采用其他治疗策略来实现双心室循环。我们提出了一种名为“心室转换”手术的新技术，在该技术中，发育不全或无法正常使用的左心室可被用作肺下心室，而右心室则作为体循环心室发挥作用。在此，我们描述了在HLHC及其他复杂病变中考虑双心室循环和心室转换手术的理论依据。
