Ventricular function of single ventricle after ventricular septation.

In this report we describe the follow-up of two patients who underwent total correction (ventricular septation) of a Van Praagh type C single ventricle. At the time of this report the patients are 93 and 37 months after operation, have led a normal life and have nearly normal hemodynamics. Ventricular cavity volumes were estimated from biplane cineangiocardiogravns. In the first patient, left and right ventricular end-diastolic volume indexes (LVEDVI and RVEDVI) were 133 and 98 ml/m2, respectively. Left plus right ventricular end-diastolic volume (LVEDV + RVEDV) was approximately 136% of the sum of the normal values of the left and right ventricular volumes. The right-to-left ventricular end-diastolic volume ratio (RVEDV/LVEDV) was 0.74 and the right-to-left ventricular end-systolic volume ratio (RVESV/ LVESV) was 0.56. Ejection fractions of the left and right ventricles (LVEF and RVEF) were 0.50 and 0.61, respectively. In the second patient, LVEDVI and RVEDVI were 139 and 93 mI/M2, respectively. LVEDV + RVEDV was approximately 166% of the sum of the normal values of the left and right ventricular volumes. RVEDV/LVEDV and RVESV/LVESV were 0.67 and 0.50, respectively. LVEF and RVEF were 0.31 and 0.49, respectively. Cineangiocardiograms showed that the prosthetic ventricular septums shifted toward the right ventricle 7-9 mm in the systolic phase. This movement of the prosthetic septum made LVEF lower than RVEF. The shift of the prosthetic septum was dependent upon the right ventricular pressure being lower than the left. Cardiac output in response to exercise was excellent in the first patient and poor in the second.