Surgical Treatments for Right Sided Single Ventricle Conditions

It is often difficult to predict which early procedure will be most helpful in supporting a newborn baby with a complex right-sided single ventricle condition. Some children are born with too much blood flowing to their lungs, others with not enough. In some conditions it is not until after birth that the doctors are able to decide exactly which of the following procedures will be needed by each child.

Shunts

Many single ventricle conditions cause a restriction of the blood supply to the lungs. As it is essential that blood flows to the lungs to collect oxygen for the body, connections must be created to re-route blood around any blockages within the heart. Surgeons will insert tubes made of either donated heart tissue or Gore-Tex (a specialised plastic) to form connections from the body circulation to the lung circulation. This treatment is often used within the first few weeks of life, as it is a simple solution to the circulation problem. Further more complex surgery will be done as the child grows.

Banding

Some children are born with a circulation that causes too much blood flow to the lungs. If the lungs are left with too high a flow, over time, it can damage the lung blood vessels. To prevent this damage occurring a band is placed around the base of the lung artery (Pulmonary Artery). This is usually removed at a later stage of surgery.

Septostomy or Septectomy

Many of the children are born with valves that are malformed so that they block the flow of blood around the heart. It is important to divert blood around the blockages by creating extra channels within the heart. Doctors may choose to create a hole between the two collecting chambers (Atria) of the heart either during a cardiac catheterisation or during surgery.

Septectomy is the surgical procedure.
Septostomy is the cardiac catheterisation procedure.
For more information on cardiac catheterisation see the section on Cardiac Tests.

The Damus Procedure

Children who are born with only one of the chambers (Ventricles) needed to pump blood around their body and who may also have a narrowing of the body artery (Aorta) may need to have surgery to aid circulation of blood from the heart to the body.

The base of the lung artery (Pulmonary Artery Trunk) is attached to the base of the body artery (Aorta) to ensure that all the blood that enters the one functioning pumping chamber will be directed around the body.

To ensure that blood also reaches the lungs a connection (Shunt) is made between the body circulation and the lung artery (Pulmonary Artery).

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Right Sided Single Ventricle Conditions:

Complex Pulmonary Atresia

Double Inlet Ventricle

Tricuspid Atresia