Septation of the univentricular heart. Transatrial approach.

The technique of septation of the univentricular heart via a transatrial approach is described in detail. Clinical details of four patients having Type A-III univentricular heart document the feasibility of working through the right-sided atrioventricular valve to place a cloth prosthesis into the ventricle to divide it into approximately equal chambers. Improved hemodynamics were observed in the postoperative period, which probably were related to retaining the integrity of the ventricular wall. This approach seems best suited to the ventricular chamber estimated to be large by echocardiography without severe pulmonary outflow tract obstruction. Techniques for enlargement of the pulmonary outflow tract are also described.