Commentary: How far will we go?

  • S. Ram Kumar
    Address reprint requests to: S. Ram Kumar, MD, PhD, FACS, Surgery and Pediatrics Children's Hospital, Los Angeles, 4650 Sunset Blvd, Mailstop #66, Los Angeles, CA 90027.
    Division of Cardiac Surgery, Department of Surgery, University of Southern California, Los Angeles, California

    Heart Institute, Children's Hospital Los Angeles, Los Angeles, California
    Search for articles by this author
Published:November 27, 2022DOI:
      Complex and innovative surgical approaches continue to provide palliative options for hypoplastic left heart syndrome, but long-term benefits are still unclear.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Seminars in Thoracic and Cardiovascular Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Newburger JW
        • Sleeper LA
        • Gaynor JW
        • et al.
        Transplant-free survival and interventions at 6 years in the SVR trial.
        Circulation. 2018; 137: 2246-2253
        • Atz AM
        • Zak V
        • Mahony L
        • et al.
        Longitudinal outcomes of patients with single ventricle after the Fontan procedure.
        J Am Coll Cardiol. 2017; 69: 2735-2744
        • Kumar SR
        • Detterich J.
        Considerations for biventricular conversion of Fontan circulation.
        Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2022; 25: 11-18
        • Marathe SP
        • Piekarski B
        • Beroukhim RS
        • et al.
        Super Glenn for staged biventricular repair: Impact on left ventricular growth?.
        Eur J Cardiothorac Surg. 2021; 60: 534-541
        • Najm HK
        • Karamlou T
        • Ahmad M
        • et al.
        Biventricular conversion in unseptatable hearts: "Ventricular switch".
        Semin Thorac Cardiovasc Surg. 2021; 33: 172-180
        • Scully BB
        • Feins EN
        • Tworetzky W
        • et al.
        Early experience with reverse double switch operation for the borderline left heart.
        Semin Thorac Cardiovasc Surg. 2022; (In Press)
        • Vincenti M
        • O'Leary PW
        • Qureshi MY
        • et al.
        Clinical impact of autologous cell therapy on hypoplastic left heart syndrome after bidirectional cavopulmonary anastomosis.
        Semin Thorac Cardiovasc Surg. 2021; 33: 791-801

      Linked Article

      • Early Experience With Reverse Double Switch Operation for the Borderline Left Heart
        Seminars in Thoracic and Cardiovascular Surgery
        • Preview
          This study reviews our early experience with the “reverse” double switch operation (R-DSO) for borderline left hearts. A retrospective review of children with borderline left hearts who underwent R-DSO between 2017 and 2021 was conducted. Patient characteristics and early hemodynamic and clinical outcomes were collected. R-DSO was performed in 8 patients with no operative or postoperative deaths; 5 underwent decompressing bidirectional Glenn. Left ventricular (LV) poor-compliance was the dominant pathophysiology.
        • Full-Text
        • PDF