Borderline Ventricles: From Evaluation to Treatment
Giuseppe Antonio Mazza,
Lilia Oreto,
Giulia Tuo,
Domenico Sirico,
Sara Moscatelli,
Giovanni Meliota,
Antonio Micari,
Paolo Guccione,
Gabriele Rinelli,
Silvia Favilli
Affiliations
Giuseppe Antonio Mazza
Division of Pediatric Cardiology, City of Health and Science University Hospital, 10126 Turin, Italy
Lilia Oreto
Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy
Giulia Tuo
Pediatric Cardiology and Cardiac Surgery Unit, Surgery Department, IRCSS Istituto Giannina Gaslini, 16147 Genoa, Italy
Domenico Sirico
Pediatric Cardiology Unit, Department of Women’s and Children’s Health, University of Padua, 35128 Padua, Italy
Sara Moscatelli
Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital, London WC1N 3JH, UK
Giovanni Meliota
Pediatric Cardiology, Giovanni XXIII Pediatric Hospital, 70126 Bari, Italy
Antonio Micari
Department of Biomedical, Dental Sciences and Morphological and Functional Images, Interventional Cardiology, University of Messina, 98122 Messina, Italy
Paolo Guccione
Mediterranean Pediatric Cardiology Center, Bambino Gesù Children Hospital, 98039 Taormina, Italy
Gabriele Rinelli
Pediatric Cardiology and Cardiac Arrhythmias and Syncope Unit, Bambino Gesù Children’s Hospital, 00146 Rome, Italy
Silvia Favilli
Department of Pediatric Cardiology, Meyer Hospital, 50139 Florence, Italy
A heart with a borderline ventricle refers to a situation where there is uncertainty about whether the left or right underdeveloped ventricle can effectively support the systemic or pulmonary circulation with appropriate filling pressures and sufficient physiological reserve. Pediatric cardiologists often deal with congenital heart diseases (CHDs) associated with various degrees of hypoplasia of the left or right ventricles. To date, no specific guidelines exist, and surgical management may be extremely variable in different centers and sometimes even in the same center at different times. Thus, the choice between the single-ventricle or biventricular approach is always controversial. The aim of this review is to better define when “small is too small and large is large enough” in order to help clinicians make the decision that could potentially affect the patient’s entire life.
