Posted on Authorea 10 Jun 2020 | The copyright holder is the author/funder. All rights reserved. No reuse without permission. | https://doi.org/10.22541/au.159183052.20182207 | This a preprint and has not been peer reviewed. Data may be preliminary. Altuntas Yurdak¨okOkan RESULTS TERM MID AND CENTERS‘ EXPERIENCE SINGLE CASES: SELECTED FOR ALTERNATIVE AN AS OPERATION SWITCH ARTERIAL PALLIATIVE hr il:Plitv reilSic Operation Switch Arterial Palliative Title: Short ¸Sa¸smazel Ahmet MD1. MD1, Aydemir Ali Numan 3, MD Yilmaz Hekim Emine MD3, Bi¸cer Altuntas MD2, H¨usn¨u Mehmet Yasemin Fırat MD1, MD1, ¸Ci¸cek Altın Korun Murat Oktay Yurdak¨ok RESULTS. Okan MD1, MD1, TERM MID AND CASES: EXPERIENCE SELECTED CENTERS‘ FOR SINGLE ALTERNATIVE AN AS OPERATION SWITCH ARTERIAL also PALLIATIVE but Arterial Ventricle, function, Single ventricular Disease, diastolic Heart of and Congenital Conclusions: transposition systolic Keywords: physiology, preserves (1/10). ventricle stages. only follow-up single following not to Operation the for with Switch for lost It arrangement patients waiting patient anatomic for obstruction. and one superior option outflow well a and palliation systemic doing provides (2/10) alternative and are series an patients arteries the as (6/10) great II in ten considered stage the mortalities completed of be two initial patients six can are 10 an other pASO of There underwent the The 7 patients and palliation. discharged. 10 stage of and completion stage Results: operation Fontan switch the next the arterial today. through survived reached palliative going patients till patient patients 10 with 2014 1 of of experience from and charts 8 clinical the starting procedure. pathway, evaluate our switch Fontan retrospectively of arterial hereby through results (DKS) palliative We palliation midterm Stansel Method: initial Kaye the patients. as evaluate Damus of to pASO, the subset is and this study for aortic Norwood (pASO) this and the operation of banding physiol- or aim pulmonary ventricle enlargement The early single foramen(BVF) the with bulboventriculer procedures. involving restricted newborns classically the for (SOS), repair, options stenosis arch management subaortic various and are discordance There ventriculoarterial ogy, Objective: and Introduction ABSTRACT Abstract 2020 10, June 2 1 rSym re hrccadCrivsua ugr riigadRsac Hospital Research Hospital and Research Training and Surgery Training Cardiovascular Kosuyolu and Kartal Thoracic Ersek Siyami Dr D iaiEskToai n adoaclrSreyTann n eerhHsia,Department Hospital, Research and Training Surgery Cardiovascular Department and Hospital, Thoracic Research Ersek and Siyami Training Dr Surgery Cardiovascular 4. and Thoracic Istanbul, Ersek Surgery, Siyami Cardiac Dr Pediatric of 3. Department Department Hospital, Hospital, Research Research and Training and Kosuyolu Training Kartal Surgery Cardiovascular 2. and Thoracic Ersek Siyami Dr 1. fPdarcCrilg,Itnu,TR Istanbul, Cardiology, Pediatric of TR Istanbul, Anesthesiology, of TR TR Istanbul, Surgery, Cardiac Pediatric of 1 mn ei Yilmaz Hekim Emine , 1 ua ¸Ci¸cek Murat , 1 ka Korun Oktay , 1 he Sasmazel Ahmet , 1 1 ia Altin Firat , 1 n ua Aydemir Numan and , 1 emtBi¸cer Mehmet , 1 2 Yasemin , Posted on Authorea 10 Jun 2020 | The copyright holder is the author/funder. All rights reserved. No reuse without permission. | https://doi.org/10.22541/au.159183052.20182207 | This a preprint and has not been peer reviewed. Data may be preliminary. n ytmcoto rc btuto ST)(avrari tnss uari tnss rarestrictive a or stenosis, subaortic lesion single-ventricle stenosis, functional aortic a (valvar with (SOTO) patients obstruction All arterial tract all ventricles. for outflow reviewed single was systemic functional database and Arteries surgical on The Great performed Board. cases the Review Palliative switch 2014. Institutional of with the from Transposition by patients starting obtained with was (SOTO), on Approval anatomy obstruction experience ventricle tract clinical outflow single systemic institutes‘ for and the (pASO) institutions‘ (TGA) of operations our analysis Switch of retrospective Arterial report includes the study is The results. study procedure(pASO) midterm this Switch their ventricles, METHOD: and Arterial AND patients single palliative 2-MATERIALS of functional of cohort the this use with for the experience on palliation clinical experience of limited stage still initial is there Since (DKS) Damus-Kaye-Stansel ftegetvsesadssei uflwosrcinhsbe umnr reybnigadari arch aortic and banding artery pulmonary transposition been with has lesions obstruction single-ventricle outflow functional in systemic for clear and palliation not reconstruction vessels of still great stage is the first outcomes of traditional better for for options options The rare surgical a between is choice literature. stenosis the current subaortic the and and anomalies discordance ventriculoarterial of with combination combined patients, heart Univentricular Operation stages. Switch following Arterial 1-INTRODUCTION for Ventricle, arrangement Single anatomic Disease, superior Heart systolic preserves a Congenital palliation. only provides Keywords: of not also It stage ventricle but single obstruction. next function, with outflow patients ventricular systemic the for (1/10). diastolic and option for arteries follow-up and palliation waiting great alternative to the an and lost of as patient well considered transposition physiology, one be completion doing can Fontan and pASO are the (2/10) The patients reached series Conclusions: the patient (6/10) the survived 1 in ten patients and mortalities of 10 II two of six stage are 8 completed other There patients the procedure. 10 switch and of arterial stage 7 palliative discharged. initial and an palliation operation underwent initial patients as 10 pASO, today. through Results: till going of 2014 patients. patients results from of of midterm starting subset charts pathway, the the Fontan this evaluate evaluate through for to retrospectively (pASO) is hereby operation study We switch this Method: arterial of Norwood palliative aim the The with or experience enlargement procedures. clinical (DKS) foramen(BVF) our bulboventriculer Stansel Kaye restricted pulmonary Damus the early the phys- repair, the ventricle and involving arch single classically aortic with (SOS), and newborns stenosis for banding subaortic options and management discordance various ventriculoarterial are iology, There Objective: and Introduction ABSTRACT 49 96 418 (216) +90 Fax: [email protected] Email: Istanbul Uskudar, Caddesi, Tıbbiye Hastanesi, com- Ersek surgery Siyami cardiac and Yurdakok cardiology Okan pediatric Author: Turkish Corresponding for conference local a in munity presented was article *The 123 nagmn ftersrce ubvnrclrfrmn(BVF) foramen bulboventricular restricted the of enlargement , 6 procedures. 2 4 n h Norwood the and , 789 5 sthe as rthe or Posted on Authorea 10 Jun 2020 | The copyright holder is the author/funder. All rights reserved. No reuse without permission. | https://doi.org/10.22541/au.159183052.20182207 | This a preprint and has not been peer reviewed. Data may be preliminary. i o epn ofrhritretosadde nPD1.Adtefis ain ntesre h had who but series recovery the for in ECMO patient on first put the was And and POD#12. usual acidosis on a died metabolic had post- and to who first interventions due the #5, further on ICU patient to re-exploration the was respond a in not patient needed and did but bedside second the deteriorated banding, on The and pulmonary #4, night deceased. a day banding operative with and on The pulmonary operation interventions arrythmia any series. switch any without persisting the arterial to palliative switch a in arterial had respond mortalities 9 palliative but not (2/10) initially, were a 2 did intervals uneventful had were was stay who There flow course hospital #3, respectively. blood post-operative and patient days, pulmonary (ICU) was 8-38) adequate unit patient (ranging for care first interventions 16 intensive further and Mean any 5-16) CPB. need (ranging measurements. not from pressure did weaning blood blood series while and artery the saturations management, pulmonary oxygen in the reconstruction to balance (%20) according to arch patients adjusted bypass. banding and off 2/10 aortic artery bypass coming pulmonary off had when loose coming saturations a patients when oxygen received flow low All patients, to the first due 142). of the shunt, Blalock-Taussig (70%) being to a 7/10 (10%); received patients 88 series, the the of (ranging 1/10 in 5/10). minutes glutaraldehyde. patient (n=5, with 108 obstruction treated pericardium, outflow was autologous (n=5, systemic with/without time obstruction Transthoracic and clamp outflow TGA through with X systemic diagnosis (DILV) Average and Ventricle days preoperative Left 42.5 TGA The was Inlet with boys. operation Double (TA) first were and Atresia of patients 5/10) Tricuspid time the were the at of (TTE) patients systemic (60%) Echocardiography and the arteries 6/10 of great age 7-155). the (pASO) mean of (ranging The operation transposition (Table1). Switch the obstruction anatomy, Arterial univentricular tract Palliative with outflow undergone patients have of palliation patients the 10 for today, through 2014 January From Washington). describe RESULTS conducted Redmond, to were Corp, analyses used All (Microsoft were data. Excel ranges categorical Microsoft for and used with medians were Means, percentages and performed. Frequencies variables. were continuous analyses statistical descriptive Standard pulmonary peri-operative a Analysis to or Statistical according but indicated flow as circulation; blood used, balanced was pulmonary a flow, adequate for blood measurements. pulmonary provide needed excessive were to prevent interventions the to shunt further banding, foramen, Blalock-Taussig no artery bulboventriculer a when the either is, of necessary, dea- it size after as when the removed left was considering was clamp bypass, artery X functioning Pulmonary cardiopulmonary pulmonary bifurcation. a from patients. artery with com- weaning pulmonary root all upward distal After artery for the the pulmonary ring. prevent to augmented used connected proximal to is is the patch trapdoor valve And maneuver pericardium neopulmonary based aorta. autologous LeCompte neoconstructed medially generous the operation. with a of coronary technique switch using pression The made open arterial augmentation. was standart simple reconstruction patch the the artery any using for without neoaorta, continue as or the to autologous flaps minutes snared to using were by 2 transferred cannulation subclavian either for were arterial left reconstructed gluteraldehyde arteries was and the aorta with carotis Nido to arcus left treated proximal Del hypoplastic the artery, antegrade pericardium The and innominate with perfusion. clamped cerebral arrested the was antegrade was to Descending aorta with heart back ascending divided. and moved distal and 28 the was clamped artery to site, clamp (X) pulmonary down cross X on cooled was The distally Aorta were cardioplegia. and distally. patients aorta dissected on the was proximally and aorta ligated (CPB) was bypass (PDA) made cardiopulmonary teriosus were cannulations on bicaval and go artery to brachiocephalic heparinization, and sternotomy median patient Following evaluate to reviewed were TECHNIQUE: data. op- SURGICAL Charts follow-up had recent echocardiograms, study. and most post-operative the and palliation, and data in pre-operative initial anatomy, operative included cardiac as were condition, procedure review pre-operative switch demographics, for arterial available an records underwent erative who foramen), bulboventricular 3 º .Ptn utsar- ductus Patent C. Posted on Authorea 10 Jun 2020 | The copyright holder is the author/funder. All rights reserved. No reuse without permission. | https://doi.org/10.22541/au.159183052.20182207 | This a preprint and has not been peer reviewed. Data may be preliminary. o rvdn nuhflwfrteac ogo uigpenny thsbe ugse httesgsof signs the even that and suggested arch been aortic was underdeveloped it has causing since It flow, birth, pregnancy. aortic coarctation. after during subnormal restrictive of in grow also development result be the the to can favoring to if arch utero going is, the in is preoperatively for stenosis BVF foramen subaortic the flow bulboventricular adequate to enough the point maintaining providing evaluating might for when not this intervention hypoplastic, mind is in additional arch keep to an aortic to flow for aspect bypass. blood need another cardiopulmonary the And the of of predict coming probability when to restriction flow, help a unreliable blood of catheterization and pulmonary as likelihood cardiac bed considered significant the or pulmonary but clinically estimate echocardiography the helpful might be by was circumference to either annulus mmHg) others root aortic BVF 10-20 aortic and the (above like the us gradient foramen of ventricular bulboventriculer ventriculo-aortic by restrictive the diameter measured and through the any SAS flow than of or blood diagnosis less pulmonary for being unpredictable criteria the size the if generally Even is defect. coronary pASO septal with poor if concern potentially stages, main with following it The pressure at making diastolic complications decreased also and future but anatomy, the PA neoaorta, perfusion. of address dislocated distortion to posteriorly occlusion, arteries, shunt of pulmonary root branch enlarged compression the necessary the the prevents reach foramen only under to a bulboventricular not pulmonary arteries which creates easier restrictive maneuver, the pulmonary trunk the prevents LeCompte artery in the the through also using pulmonary valve of bed is pASO the advantage functioning vascular potential to BVF. pulmonary a another chamber And the the keeping ventricular preventing for rudimentary by of thus protection the chamber stenosis, restriction and natural of ventricular subaortic further obstruction connection of single and The subpulmonary relief the position. ventricle a The of into single tract. dysfunction obstruction outflow the diastolic systemic subaortic of the the hypertrophy through ”switch” myocardial flow to laminar beneficial a earlier a is create presented underwent well operation patient are this pASO 1 of the and of BDG advantages potential to The on results went patients short-term them 6 good of with reported 2 switch and and stenosis, technique Freedom the subaortic by procedure developed Fontan was and later literature hearts associates univentricular the and with in Karl procedure procedure. switch Fontan simultaneous arterial 1980 palliative in the colleagues of presentation extracardiac earliest an The with operation Fontan uneventful an DISCUSSION showed had catheterization patient cardiac the satisfactory preoperative with and conduit. 11 and was distribution mPAP yet coaptation. artery valve stage reasonable pulmonary and completion function Fontan ventricular good this the arch, at reached unobstructed needed patient preserved. were well 1 interventions were well. Only functions further as evaluated ventricular no reconstruction also The were and artery 1). foramen reconstruction catheterization (Picture pulmonary bulboventriculer arch stage and the needed well, aortic resi- echocardiography patients functioning an for transthoracic of were needed valves arch with 2/7 semilunar patients distal and and 1/7 previous the valves mean and AV II. of the The The operation stage angioplasty of operation. Glenn before balloon tightening Glenn to catheterization underwent the needed concomitant patient the before patient another during catheterization one gradient And cardiac initially only dual operation. a was acceptable, the had patient were during and (mPAP) the band II pressures since stage artery visit, reached treatment. pulmonary clinic patients after 10 post-operative home discharged back of but first tracheostomy, went 7 the a and included country after which nearby follow-up course a lost postoperative from long and accepted a months had 2 shunt, BT after the with pASO a 1011 hr sas erae edfrassei oP hn,a hn hc are h ikof risk the carries which shunt a as shunt, PA to systemic a for need decreased also is There . 8 7 aorGytadclege,as eotd7ptet h newn alaiearterial palliative underwent who patients 7 reported also colleagues, and Lacour-Gayet . h ecie ainswt rcsi tei htudretatra wthand switch arterial underwent that atresia tricuspid with patients 2 described who , 9 u otnplito tg n utblt a o enreported. been not has suitability and stage palliation Fontan but , 81314 hs roeaiemaueet fteBFadthe and BVF the of measurements preoperative These . 4 1011 eas eiv httebscprinciple basic the that believe also we ; 101112 . Posted on Authorea 10 Jun 2020 | The copyright holder is the author/funder. All rights reserved. No reuse without permission. | https://doi.org/10.22541/au.159183052.20182207 | This a preprint and has not been peer reviewed. Data may be preliminary. ept upr neryagesv praht ueotptnillt opiain n aiiaesuccessful facilitate and will complications patients. study late of potential our out subset that rule think complicated We to these approach that procedure. of Fontan aggressive preservation palliation early the function an for diastolic support candidates early and to good their systolic operating help ventricles simplifies of but the single tract with benefits of outflow period patients long-term out they systemic make ischemic offer since coming harmonious remarkable and a procedures, when and with management palliative foramen physiology other bulboventricular post-operative run banded the the bypass post-operative of of The long most because room. than a physiology postoperatively with banded manage have operation, to mostly easier complex are a as patients patients is considered these ventricle pASO single be discordant may summary; ventriculo-arterial procedure In pati- risk switch obstruction. the high arterial outlet these to palliative systemic of related the a management factors with 10-30%, between the like as literature for anatomy etc. high current alternative the factors an as the and other reported in weight vary and being the mortality procedures procedure, reporting, DKS the of completion Fontan the undergoing era with ent and the with up patients on Norwood end of depending the to subset institutes, palliation for this primary mortality in the operative obstruction as sub-aortic The arteries the great address transposed arteries to technique and great used this ventricle the of been single variations of have The transposition palliation. operation single-ventricle of in Norwood repair use the for biventricular extended centers. for then division many were described indications in the originally The extensively was is aortic used procedure BVF the been DKS through the has The on of approach carried enlargement this is with SAS enlargement recurrent SAS the bands and surgical of muscle for injury, rim subaortic the employed inferior additional if was the of young jeopardy, to that resection the in close and option in be be surgical difficult to also Another quite appears might which technically annulus. valve system be aortic conduction can the or a resection to BVF injury with subaortic risking and annulus neonate; BVF aortic or the infant the of accordingly. of enlargement addressed >10-20 surgical size be echocardiography( The the to Doppler needs than by and less annulus restrictive is as aortic VSD considered to mentioned the ventricle the of dominant to size mmHg) the due septal the from unreliable ventricular when gradient the often of measurable but is size above, slit-like echocardiography the a of features Preoperative mostly estimation is anatomic and importance. which rim stenosis, utmost muscular subaortic completely carries with a anticipated. patients defect with UVH or opening the present like in is BVF buttonhole the or stenosis is subaortic feature when anatomical key palliation The as myocardial banding PAB-related artery to pulmonary due abandon size to BVF in reduction further spontaneous hypertrophy also for is tendency there a term hypertrophy longer is the there In ventricle, protect PAB. to itself single effective by period functional BVF neonatal with the the of in patients narrowing palliation in initial vasculature as advocated pulmonary been the has BVF ventricle, banding the artery single pulmonary with of Although patients enlargement repair of included arch group have with this stenosis banding in artery subaortic conflicts these and address discordance, to ventriculoarterial univentricular obstruction options the outflow preserve management systemic pulmonary to other palliation. the adequate needs Various excessive addressing initial also maintain by of strategy after and function control The stage resistance diastolic the saturations. vascular next and oxygen require satisfactory systolic pulmonary the both provide future procedure, to to Fontan pulmonary prevent flow safely a and to adequate blood patient or flow arteries and the (BDG) great blood systemic operation carrying the pulmonary unrestricted Glenn is of bidirectional provide objective transposition a to primary Either hearts, basically The univentricular is flow. with obstruction infants blood tract for outflow palliation initial systemic of aim The 813 n hnacmaidwt nudreeoe yolsi otcac;te h V a be can BVF the then arch; aortic hypoplastic underdeveloped an with accompanied when and 1516 3 uari btuto a opiaeteftr otnplito yidcn ventricular inducing by palliation Fontan future the complicate may obstruction Subaortic . edn osbnoada shmaaddatlcdsucinadti a e oegroups some led has this and dysfunction diastolic and ischemia subendocardial to leading , 17 123 raclrtdb h meit euto ndatlchatvlm fe an after volume heart diastolic in reduction immediate the by accelerated or oictoso h DKS the of modifications , 4 ept oeta opiain fhatbok coronary block, heart of complications potential Despite . 5 1320 u osdrn h vrl owo procedures’ Norwood overall the considering but 6 rNorwood or 5 procedure. 1516 . 4 pulmonary , 19 and 18 6 . . Posted on Authorea 10 Jun 2020 | The copyright holder is the author/funder. All rights reserved. No reuse without permission. | https://doi.org/10.22541/au.159183052.20182207 | This a preprint and has not been peer reviewed. Data may be preliminary. .Lcu-ae ,Sra ,FrotL ta.Eryplito fuietiua erswt uari stenosis subaortic with hearts univentricular hearts. of univentricular palliation Early in al. et stenosis L, Fermont subaortic A, for Serraf F, Operations Lacour-Gayet 9. RBB. Mee S, Surg Sano Thorac KG, the Ann Watterson of and TR, reimplantation, transposition Karl artery atresia, 8. coronary Tricuspid switch, using RD. arterial by Rowe results conduit. Repair valved GA, artery. atrioventricular heart: Trusler pulmonary right univentricular RS, banded Fowler and in arteries, WG, great obstruction Williams RM, Subaortic Freedom operation. al. 7. Stansel et P, Damus-Kaye ViJay barrel doi:10.1016/j.ejcts.2008.09.037 M, double Rodefeld the AC, Fiore Ste- Subaortic 6. by Complicated Double-Inlet) or Infancy. (Single- in Ventricle Options Single P. Surgical Lang nosis: AR, Castaneda subaortic connections. RA, of Jonas ventriculoarterial 5. relief pati- of discordant 43 results with Long-term of C. connection Surg Lincoln courses atrioventricular Thorac RH, univentricular Anderson the DB, in Ross of stenosis, EA, stenosis banding. analysis Subaortic Shinebourne artery M, an RD. Jahangiri pulmonary 4. Rowe artery: by GA, pulmonary Trusler palliated the WG, heart of doi:10.1161/01.cir.73.4.758 Williams univentricular banding JF, with and Smallhorn ents heart, LN, univentricular Benson the surgical RM, Staged Freedom JW. 3. Brown flow. MW, blood Turrentine pulmonary unobstructed DA, with Girod infants Surg in 1995:515-520. MS, ventricle online single Schamberger Published functional M, Surgery. of repair Ruzmetov aralOthoraeic al. MD, et Rodefeld BR, 2. Keeton JG, Leblanc SA, Webber publi- 1. and research the for support financial REFERENCES no received and article. interest this future of of conflicts for cation no reevaluated declared be being, author(s)‘ to time The Funding need the and results for Interests long-term with midterm Conflicting The go of is above. to Declaration follow-up reasons decided The given were bias. the patients selection for the a f/u mostly discussions. creates lost but which patient pattern, 1 room, retrospective and operating its the of with in because possible pASO limited is is study which This dysfunction functioning diastolic load. a volume left future Having ventricular of probable procedure. in Limitations probability increase the DKS the with prevents of resulting excludes shunts, also complication anteriorly, involving place possible arteries procedures a pulmonary in valve is the BVF which pulling pulmonary further entrapment, by the addition for artery pASO, in prevents maneuver pulmonary of tendency physiology LeCompte advantages postoperatively. banding less resistance the pulmonary vascular offers to pulmonary of hypertrophy and the management systemic for myocardial medical in function fluctuations further easier diastolic the or considerably of for systolic Thus, prevention preserve them ventricle restriction. to dominant prepare The pattern the also flow and settings. but tract systemic outflow future laminar period systemic unrestricted neonatal the an between the alignment maintains through natural systemic and a and passage provides arteries safe pASO great term. a the long of creates transposition obstruction hearts, univentricular tract with outflow infants for palliation ultimate The CONCLUSION 052()9995 doi:10.1016/j.ejcts.2005.01.066 2005;27(6):949-955. . 017()9790 doi:10.1016/S0003-4975(00)02544-3 2001;71(3):907-910. . 915()4048 doi:10.1016/0003-4975(91)90901-2 1991;52(3):420-428. . n hrcSurg Thorac Ann hrcCrivs Surg Cardiovasc Thorac J 953()3136 doi:10.1016/S0003-4975(10)62633-1 1985;39(4):361-366. . 6 u adotoai Surg Cardio-thoracic J Eur 1980;80(4):621-628. . Circulation u Cardio-thoracic J Eur 2009;35(1):141-146. . 1986;73(4):758-764. . Ann Posted on Authorea 10 Jun 2020 | The copyright holder is the author/funder. All rights reserved. No reuse without permission. | https://doi.org/10.22541/au.159183052.20182207 | This a preprint and has not been peer reviewed. Data may be preliminary. experience-and-mid-term-results the in arterial-switch-operation-as-an-alternative-for-selected-cases-single-centers- procedure 1.docx Norwood Table the of Outcome ventricle. left file WJ. single Hosted Brawn functional DJ, and arteries Barron doi:10.1016/j.ejcts.2008.09.016 great TJ, 2009;35(1):149-155. the . Jones of transposition R, 1991. of online Hosein Published setting Procedure. AA, Damus-Fontan The Lotto al. 20. et JD, Waldman RD, Mainwaring JJ, Lamberti it. 19. do to How H. obstruction. followi- Stansel subaortic 18. outcome of pathology late The and SY. Commandments”? early doi:10.1016/S0003-4975(98)00576-1 Ho “Two RH, influencing The Anderson Factors era. 17. al. current the et SP, in doi:10.1016/j.ejcts.2006.11.043 McGuirk procedure 2007;31(3):344-353. Fontan AJB, the Clarke ng Ventricular RBM, factors. operation. Fontan Hosein risk The as 16. LMJ. operation Bargeron of AD, date Pacifico JW, and Kirklin age, With hypertrophy, EH, Atresia Blackstone Tricuspid JK, or Ventricle Kirklin Left 15. Double-Inlet of Revisitation al. et Arteries. BS, Great options Kwon Transposed Surgical JS, hearts: Baek univentricular WK, Park in 14. obstruction Systemic al. et F, neonates. Lacour-Gayet for S, Conte as A, Switch Serraf Arterial 13. Palliative Subaortic Mir´o and L. Gonz´alez Physiology M, Single-ventricle R, With Patients Castillo in Stenosis. DC, Procedure Fontan Albert the Before J-I, Treatment First-line Zabala JM, palliative the Gil-Jaurena Ven- after 12. Outcomes Single CD. anatomy. Fraser single-ventricle PA, Undergoing with Katigbak neonates A, doi:10.1016/j.athoracsur.2012.09.028 Patients in Liou ED, operation McKenzie in switch KE, arterial Carberry Obstruction JS, Heinle Outlet 11. Systemic of doi:10.1053/j.pcsu.2009.01.006 Palliation. Management CD. tricle Fraser 10. option. switch 1245. arterial The discordance. ventriculoarterial and e sanl ado EgihEd (English Espa˜nola Cardiol Rev n hrcSurg Thorac Ann vial at available ei hrcCrivs ugPdarCr ugAnnu Surg Card Pediatr Surg Cardiovasc Thorac Semin n hrcSurg Thorac Ann n hrcSurg Thorac Ann 956()9097 doi:10.1016/0003-4975(95)00520-U 1995;60(4):970-977. . https://authorea.com/users/331975/articles/458465-palliative- 036()5355 doi:10.1016/j.rec.2013.01.020 2013;66(7):553-555. . 09174:2211.doi:10.1016/j.athoracsur.2018.11.052 2019;107(4):1212-1217. . 951()5557 doi:10.1093/occmed/kqx180 1975;19(5):565-567. . 7 hrcCrivs Surg Cardiovasc Thorac J hrcCrivs Surg Cardiovasc Thorac J n hrcSurg Thorac Ann n hrcSurg Thorac Ann u adotoai Surg Cardio-thoracic J Eur u adotoai Surg Cardio-thoracic J Eur 1986;92(6):1049-1064. . 1998;66(2):644-648. . 2013;95(1):212-219. . 2009;12(1):70-75. . 1992;104(5):1238- . . Posted on Authorea 10 Jun 2020 | The copyright holder is the author/funder. All rights reserved. No reuse without permission. | https://doi.org/10.22541/au.159183052.20182207 | This a preprint and has not been peer reviewed. Data may be preliminary. 8