Problem and strategy in surgical treatment of single ventricle

Single ventricle disease is a complex congenital heart anomaly with a high operative mortality. In the past few years, much progress had been made in surgical treatment of single ventricle. However, some problems in the diagnosis and treatment still remained. Based on the author's experience, the concept, morphology, and pathophysiology were reviewed and indications of various surgical techniques, problems during the operation and post-operation with their strategies were discussed in this article. Most single ventricular diseases are treated by Fontan series surgery; in which better results can be achieved through extra-cardiac conduct. Ventricular separation which is better than Fontan series surgery can be performed on those qualified. If the pulmonary vessels are maldeveloped, systematic to pulmonary shunt is preferred to promote the development of pulmonary vessels. When pulmonary hypertension occurs, Banding procedure is suggested to prevent pathologic changes of pulmonary vessels. The development of pulmonary vessels and total pulmonary resistance varies greatly from patients at different ages. Choosing appropriate patients is the key to obtain satisfactory outcome.The pulmonary vessel resistance and cardiac function status are the most important factors for successful operation.