DILV; Single ventricle; Common ventricle
Surgery is needed to improve blood circulation through the body and into the lungs. The most common surgeries to treat DILV are the ones leading up to the Fontan operation, which may require several stages. (Each stage in the Fontan procedure is a separate surgery.)
The first surgery may be needed within the baby's first few days of life. Afterward, the baby will usually go home. The child will need to take one or more daily medications and be closely followed by a pediatric cardiologist, who will decide when the second stage of surgery should be done.
The next surgery (or first surgery, if the baby didn't need the procedure mentioned above) is called the bidirectional Glenn shunt or Hemifontan procedure. This surgery is usually done when the child is 4 - 6 months old.
After the child has had the above operations, he or she may still look blue (cyanotic). The final step is called the Fontan procedure. This surgery is usually performed when the child is 18 months - 3 years old. After this final step, the baby is no longer cyanotic.
The Fontan operation does not create normal circulation in the body, but it creates the type of circulation a child can live and grow with. However, even this surgery carries many risks and complications.
A child may need additional types of surgeries for related defects or to extend survival while waiting for the Fontan procedure.
The doctor may prescribe your child medication before and after surgery. Medications may include:
For the most severe cases of DILV, a heart transplant may be recommended.
Children with this congenital heart disease should take antibiotics before dental treatment. This prevents infections around the heart.
See also: Pediatric heart surgery
DILV is usually a very complex, hard-to-treat heart defect. How well the baby does depends on several factors. They include:
Advances in surgical techniques allow many infants with DILV to reach adulthood. However, many of these children and adults require regular follow-ups, face many complications, and may be limited in the type of physical activities they can pursue.
Complications of DILV include:
Park MK. Park: Pediatric Cardiology for Practitioners, 5th ed. Philadelphia, PA: Mosby Elsevier; 2008:283-287:chap 14.
Kliegman RM, Behrman RE, Jenson HB, Stanton BF. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007.
Townsend Jr. CM, Beauchamp RD, Evers BM, et al, eds. Townsend: Sabiston Textbook of Surgery, 18th ed. Philadelphia, PA: Saunders Elsevier; 2008:1777-1783: chap 43.
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