The affiliated, multidisciplinary team of pediatric heart surgeons, pediatric cardiologists, and other specialists at the Children’s Heart Institute1 at Children’s Memorial Hermann Hospital – named one of the top children's hospitals nationally in Cardiology & Heart Surgery by U.S. News & World Report – aims to give each child the opportunity to live a normal life by restoring the normal function of his or her heart with the greatest degree of safety.
The affiliated team offers patients specialized and innovative treatments such as the biventricular repair, biventricular conversion, and ventricular recruitment for some of the most complex issues involving a single ventricle defect.
The team works to rearrange the connections of a child’s heart, starting with a single functional pumping chamber or ventricle and converting it into a normal, two-ventricle arrangement.
Full biventricular repairs are an alternative option for many newborns and children who would typically undergo or have previously undergone traditional treatment methods (i.e., surgical procedures including the Norwood, Glenn, and Fontan operations). This capability is very unique and progressive, and it can result in fewer surgeries and better long-term quality of life for many children.
The normal heart has four chambers: two upper chambers called atria, which receive blood into the heart, and two lower chambers called ventricles, which pump blood out of the heart. Many children with a congenital heart defect have only one functional ventricle, or pumping chamber, that is able to pump blood effectively.
Biventricular repair, biventricular conversion, and ventricular recruitment are treatment options for complex congenital heart patients born with a single ventricle defect, or a small right or left heart.
Traditionally, the treatment for these types of heart conditions involves a single ventricle palliation: a series of open heart surgeries (the Norwood, Glenn, and Fontan procedures) to allow the single working ventricle to pump blood to the body, leaving the blue blood to flow passively to the lungs. This traditional treatment option, while effective in many patients, can ultimately lead to heart failure, decreased quality of life, and potential need for heart transplantation.
For many children, biventricular repair and biventricular conversion offer an alternative, advanced treatment option for those previously managed as single ventricles. The types of biventricular repair procedures are listed below:
Congenital heart defects may be diagnosed during pregnancy with a fetal echocardiogram, which is a specialized ultrasound of the fetal heart. The affiliated physicians in the Fetal Cardiology Program at The Fetal Center will confirm a diagnosis and prepare a delivery plan for both mom and baby. The multidisciplinary team of affiliated fetal and pediatric heart specialists will also develop the baby's immediate treatment plan following delivery.
If the heart defect is not diagnosed in utero, and suspicion of a heart defect develops after the baby is born, a pediatrician will refer the patient to a neonatologist or a pediatric heart specialist to determine the diagnosis. At Children’s Memorial Hermann Hospital, our advanced diagnostic imaging includes echocardiography, cardiac MRI, CT scanning and other technology. Imaging scans performed help the affiliated team determine the appropriate plan of care.
At the Children’s Heart Institute, the affiliated team tailors each plan of care to help ensure that every child receives the best individualized option with the minimum amount of risk. Along with a thorough review of pediatric imaging results, the affiliated team provides a comprehensive evaluation of each patient and consults with the patient’s family to determine the best treatment approach for the child. Each patient is evaluated to determine if he or she is a candidate for a biventricular repair procedure.
For patients who meet the criteria to undergo a biventricular repair, this treatment approach can result in fewer operations throughout a child’s lifetime and has the potential to improve long-term quality of life. There are risks associated with all treatment options, but the affiliated team’s experience has shown that biventricular repairs and conversions offer children an excellent opportunity for a normal life. Not all patients qualify for this procedure, but each child will be carefully evaluated in an effort to find hope and solutions for each patient.
The affiliated team utilizes other advanced treatment options and techniques, including congenital heart optimization, for children who may not meet the specific criteria for a biventricular repair procedure.
Below is a list of heart conditions that may be treated with a biventricular repair, biventricular conversion, or ventricular recruitment approach in children who qualify:
The affiliated team may follow a child’s care throughout life into adulthood. Patients will see a cardiologist regularly as well as obtain an echocardiogram and other studies as needed. The affiliated team individualizes care to the needs (and anatomy) of each child.
At Children’s Heart Institute at Children’s Memorial Hermann Hospital, patients with congenital or acquired heart disorders receive hands-on specialized care 24/7 from a team of affiliated physicians and specialty-trained nurses who aim to deliver the best possible outcomes.
Children’s Memorial Hermann Hospital was named one of the top children's hospitals nationally in Cardiology & Heart Surgery by U.S. News & World Report. In addition, Children’s Heart Institute is among the top congenital heart surgery programs in North America for patient care and outcomes, according to the Fall 2019 Society of Thoracic Surgeons (STS) Congenital Heart Surgery Database Report of 118 STS participating programs.
In collaboration with various subspecialties, the affiliated team provides comprehensive care for newborns, children and adolescents, with the ability to transition into adult congenital cardiac care. Team members have the experience and skills necessary to offer innovative treatment methods and specialized services, including, but not limited to:
With the Level IV Neonatal Intensive Care Unit (NICU) and a dedicated Children’s Heart Institute Intensive Care Unit at Children’s Memorial Hermann Hospital, critical heart patients have access to quality, specialized care. By utilizing state-of-the-art techniques, the team at Children’s Heart Institute strives to offer patients with the most complex problems the greatest opportunity for a normal life.
For Demetric Fisher, her daughter Kaydan's health was such a test. Born on June 20, 2012, in Jackson, Miss., little Kaydan’s life led her family on an emotional rollercoaster that would shape their lives for years to come.
Born with a hypoplastic left ventricle too small to function normally, Kingston Murriel was treated in Jackson by Jorge D. Salazar, MD, and Avichal Aggarwal, MD. For many children, the safest accepted option for a single-ventricle heart is to undergo staged surgeries culminating in a Fontan proce...
Rasheed Alshammari had been on the waiting list for a heart transplant at a California hospital for over a year. When the surgeon who was to perform the transplant left the hospital, Rasheed was removed from the list.
Karen and Taylor Mims spent the first six years of their son’s life trying to accept the fact that he was born with half a heart and would eventually require a heart transplant. Now, thanks to an innovative procedure being performed by affiliated pediatric heart surgeons at Children’s...
Abigail’s heart condition was one that started before birth and worsened with time. She suffered from a heart defect called Congenitally Corrected Transposition of the Great Arteries (CCTGA), a rare condition in which the connections of her heart developed backwards. But a life-changing sur...
During her 20-week ultrasound, Savannah’s obstetrician diagnosed that her unborn baby’s heart was abnormally small and referred her to a maternal fetal medicine specialist. The specialist ordered a dedicated fetal echocardiogram (“echo”), a specialized ultrasound of the fe...
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The Children’s Heart Institute is a collaboration between the affiliated physicians at McGovern Medical School at UTHealth Houston and Children’s Memorial Hermann Hospital. Typically, patients are seen on an outpatient basis at a UT Physicians clinic with all inpatient procedures performed at Children’s Memorial Hermann Hospital.
Note: The information presented on this page is educational and is intended to develop a general knowledge of the condition and/or procedure. It is not intended as medical advice or the practice of medicine. Specific aspects of your condition, expected outcomes, and care should be addressed and answered after consultation with your physician. Not all affiliated physicians are Memorial Hermann employees.
03/2018 – This page was updated and approved by an affiliated pediatric physician at the Children’s Heart Institute.
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