Single ventricle lesions

Katja M. Gist*, Steven M. Schwartz, Catherine D. Krawczeski, David P. Nelson, Derek S. Wheeler

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapter

1 Scopus citations

Abstract

The univentricular or single ventricle heart applies to a heterogeneous group of congenital cardiac lesions with wide variability in the pre-and post-operative anatomy and physiology. The management of a child with single ventricle physiology represents a unique challenge to the intensive care physician both in the pre-and post-operative period, as these children often respond differently to common interventions such as supplemental oxygen, mechanical ventilation, and vasoactive infusions differently than children with biventricular physiology. Surgical strategies for patients with a univentricular heart typically include multiple stages of palliation with the goal of separating the systemic and pulmonary circulations and thereby restoring near normal cardiac physiology. Given the complexity of these lesions and their repair, children may be more adversely affected by inter-current illness, experience limitations in activities of daily living, and succumb to complications seen commonly in the inter-stage periods. The unique physiology encountered in single ventricle heart disease represents the sine qua non of pediatric cardiac intensive care, and it is therefore imperative that pediatric intensivists have a thorough understanding of its nuances. This chapter will address the important physiologic issues that arise in the care of infants and children with a univentricular heart both before and after surgery.

Original languageEnglish (US)
Title of host publicationPediatric Critical Care Medicine
Subtitle of host publicationVolume 2: Respiratory, Cardiovascular and Central Nervous Systems
PublisherSpringer-Verlag London Ltd
Pages397-415
Number of pages19
ISBN (Electronic)9781447163565
ISBN (Print)9781447163558
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Keywords

  • Fontan
  • Glenn
  • Hemi-Fontan
  • Hypoplastic left heart syndrome
  • Norwood
  • Qp/Qs
  • Single ventricle
  • Univentricular

ASJC Scopus subject areas

  • Medicine(all)

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