Which two ventricles cannot be used for a biventricular repair? Echocardiographic assessment

Background. A variety of factors can influence the suitability of a congenitally malformed heart for biventricular repair, including size, morphology, function, and dimensions and function of the inflow and outflow among others. Although certain features have been identified that may indicate a lower probability of successful biventricular repair, our ability to predict whether a particular patient will be able to tolerate completely separate in-series systemic and pulmonary circulations remains imperfect. Methods and Results. In this review, we discuss the echocardiographic evaluation of various factors that can influence a patient's suitability for two ventricle repair. We call on our own experience, and illustrate our discussion with a number of echocardiographic images. Conclusions. In most cases, echocardiography allows for full assessment of the anatomic and functional features that influence whether a patient is a suitable candidate for biventricular repair. Although a number of indices have been developed for determining who can and cannot be expected to undergo successful two ventricle repair, there remains substantial room for progress in this area. (C) 1998 by The Society of Thoracic Surgeons.