Borderline Right Ventricles and One and a Half Ventricle Circulation

One and a half ventricle repair (1.5VR)One and a half ventricle (1.5 ventricle) is a combination of intracardiac repair for hypoplastic subpulmonic ventricleVentricles with bidirectional cavopulmonary connectionBidirectional cavopulmonary connection. While this surgery was originally developed to address PA/IVS this procedure is performed when the left ventricleVentricles (LV) is functionally normal but the right ventricleVentricles (RVBorderline right ventricle (RV)) is incapable of handling the entire cardiac output. Common indications include hypoplasia of the RVBorderline right ventricle (RV) or tricuspid valveTricuspid valve (TV), or well sized RVBorderline right ventricle (RV) with acute or chronic dysfunction. 1.5VR decreases the volume load on the suboptimal RVBorderline right ventricle (RV), provides pulsatile pulmonary blood flow, roughly equal systemic and pulmonary flow, and normal systemic oxygen saturations. There has been an improvement in surgical outcome over time with early mortality estimated at 0 to 10% and long-term survivalSurvival 80.1% and 69.3% at 10 and 20 years, respectively. Patients with 1.5VR have a trend towards higher oxygen consumption (VO2) when exercising compared to patients with FontanFontan circulation and there have been no reported complications of high venous pressure like protein-losing enteropathy or chronic liver congestion.