Specific Injuries Management in the Postoperative of Congenital Heart Diseases (II): Univentricular Hearts
2015
It is very important to understand
that the univentricular heart surgery is just palliative, not being in anyway a
definitive or curative surgery, but nowadays it’s the best initial treatment of
this complex heart disease. The fundamental philosophy of treatment of every
univentricular heart is to ensure the flow system and/or restrict the lung
flow. Thus, initially a patient with univentricular heart who is undergoing
surgery may need to ensure systemic flow (reconstruction of the aortic arch type Norwood), to restrict the
lung flow (pulmonary banding) or to provide enough pulmonary flow (pulmonary-systemic
fistulae). However, some heart diseases with univentricular physiology remain
“balanced” autonomously, until the “second” stage of palliation is performed
(cavo-pulmonary anastomosis type Glenn), but others require performance of
pulmonary banding, if there’s no native lung protection and/or repair of the
systemic circuit in a first stage, to reach next palliation steps in the best
possible conditions.
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