Around 3-4 children born with congenital heart diseases have
univentricular hearts, where the prognosis of univentricular hearts is
poor in the past, with a survival rate of less than 50% during the
first year and 10% during the first ten years of life. Based on a
literature search, current advances in perioperative management of
neonates with complex congenital heart diseases have increased their
survival rate by 85%. To aid cardiothoracic surgeons worldwide, this
comprehensive literature review will focus on the perioperative
management of staged palliation surgery for functional univentricular
hearts, considering current trends as well as how we do it in our
centre. Our review article specifially discusses perioperative
strategies regarding surgical considerations, current techniques, to
deal with overshunting and undershunting during the first stage of
palliation surgery. This article also gives an overview on when a
patient is suitable to go through with the next stage of the procedure,
which is the implementation of a bidirectional cavopulmonary shunt or
the Hemi-Fontan procedure. Lastly, this article gives a comprehensive
approach regarding perioperative strategies of the Fontan procedure,
which include patient criteria, current surgical techniques,
postoperative management, as well as the use of anticoagulants after the
Fontan procedure.
Clinical Features and Perioperative Management of Congenital Tracheal Stenosis in Patients with Congenital Heart Diseases
