{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T20:59:51Z","timestamp":1777409991076,"version":"3.51.4"},"reference-count":28,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2023,7,3]],"date-time":"2023-07-03T00:00:00Z","timestamp":1688342400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1047951123001646_as1\"><jats:title>Objectives:<\/jats:title><jats:p>The indications, timing, and results of the so-called \u201cone-and-a-half ventricle repair\u201d, as a surgical alternative to the creation of the Fontan circulation, or high-risk biventricular repair, currently remain nebulous. We aimed to clarify these issues.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951123001646_as2\"><jats:title>Methods:<\/jats:title><jats:p>We reviewed a total of 201 investigations, assessing selection of candidates, the need for atrial septal fenestration, the fate of an unligated azygos vein and free pulmonary regurgitation, the concerns regarding reverse pulsatile flow in the superior caval vein, the growth potential and function of the subpulmonary ventricle, and the role of the superior cavopulmonary connections as an interstage procedure prior to biventricular repair, or as a salvage procedure. We also assessed subsequent eligibility for conversion to biventricular repair and long-term functional results.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951123001646_as3\"><jats:title>Results:<\/jats:title><jats:p>Reported operative mortalities ranged from 3% to 20%, depending on the era of surgical repair with 7% risk of complications due to a pulsatile superior caval vein, up to one-third incidence of supraventricular arrhythmias, and a small risk of anastomotic takedown of the superior cavopulmonary connection. Actuarial survival was between 80% and 90% at 10 years, with two-thirds of patients in good shape after 20 years. We found no reported instances of plastic bronchitis, protein-losing enteropathy, or hepatic cirrhosis.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951123001646_as4\"><jats:title>Conclusions:<\/jats:title><jats:p>The so-called \u201cone-and-a-half ventricular repair\u201d, which is better described as production of one-and-a-half circulations can be performed as a definitive palliative procedure with an acceptable risk similar to that of conversion to the Fontan circulation. The operation reduces the surgical risk for biventricular repair and reverses the Fontan paradox.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1047951123001646","type":"journal-article","created":{"date-parts":[[2023,7,3]],"date-time":"2023-07-03T03:59:44Z","timestamp":1688356784000},"page":"1497-1505","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":6,"title":["The so-called \u201cone-and-a-half\u201d ventricular repair: where are we after 40 years?"],"prefix":"10.1017","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1672-1502","authenticated-orcid":false,"given":"Ujjwal Kumar","family":"Chowdhury","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5163-9021","authenticated-orcid":false,"given":"Robert H.","family":"Anderson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6786-8304","authenticated-orcid":false,"given":"Niraj Nirmal","family":"Pandey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sundeep","family":"Mishra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lakshmi Kumari","family":"Sankhyan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niwin","family":"George","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maroof A.","family":"Khan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shikha","family":"Goja","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2023,7,3]]},"reference":[{"key":"S1047951123001646_ref13","doi-asserted-by":"publisher","DOI":"10.1007\/s11748-020-01379-2"},{"key":"S1047951123001646_ref5","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezaa289"},{"key":"S1047951123001646_ref22","doi-asserted-by":"publisher","DOI":"10.1136\/bmjsem-2019-000620"},{"key":"S1047951123001646_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-7940(02)00669-3"},{"key":"S1047951123001646_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2010.07.048"},{"key":"S1047951123001646_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(98)00574-8"},{"key":"S1047951123001646_ref21","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"S1047951123001646_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)34520-9"},{"key":"S1047951123001646_ref27","first-page":"577","article-title":"L\u2019intervento di anastomosi vena cava-arteria polmonare nella tetrade di Fallot e in altre cardiopatie [Surgical creation of the vena cava\u2014pulmonary artery anastomosis in Fallot tetralogy and other cardiac pathology]","volume":"9","author":"Dogliotti","year":"1961","journal-title":"Minerva Cardioangiol"},{"key":"S1047951123001646_ref28","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(99)00877-2"},{"key":"S1047951123001646_ref18","doi-asserted-by":"publisher","DOI":"10.1053\/tc.2000.6505"},{"key":"S1047951123001646_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)01832-6"},{"key":"S1047951123001646_ref26","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM195807172590304"},{"key":"S1047951123001646_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(98)00575-X"},{"key":"S1047951123001646_ref23","first-page":"760","article-title":"Su una nuova anastomosi vasale per la terapia chirurgica di alcuni vizi cardiovasculari [A new vascular anastomosis for surgical treatment of some cardiovascular anomalies]","volume":"6","author":"Carlon","year":"1950","journal-title":"Ital Chir"},{"key":"S1047951123001646_ref16","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.41.3.281"},{"key":"S1047951123001646_ref25","first-page":"189","article-title":"Circulatory by-pass of the right heart II. further observation on vena-caval-pulmonary artery shunts","volume":"6","author":"Patino","year":"1955","journal-title":"Surg Forum"},{"key":"S1047951123001646_ref19","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(01)02517-6"},{"key":"S1047951123001646_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2005.05.052"},{"key":"S1047951123001646_ref7","doi-asserted-by":"publisher","DOI":"10.21037\/tp.2017.08.04"},{"key":"S1047951123001646_ref24","first-page":"147","article-title":"Circulatory by-pass of the right heart. 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