PMC:6640909 / 83658-84969 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/6640909","sourcedb":"PMC","sourceid":"6640909","source_url":"https://www.ncbi.nlm.nih.gov/pmc/6640909","text":"11.3 Single ventricle—Fontan haemodynamics\nApproximately 5–10% of children born with CHD suffer from an underdeveloped LV or RV, leading to single ventricle physiology. Large studies on the use of MCS in patients with a single ventricle are lacking. Only case reports or small case series have been published, and they report high mortality rates [283, 291, 292]. However, implantation of VADs in various locations seems to be feasible.\nThe feasibility of VAD support for Glenn circulation has been reported with mixed results [283, 292, 293]. After the Fontan circulation has been created, there are 2 possibilities of failure: systemic ventricular failure or failure at the level of the cavopulmonary connection. Currently available VADs are designed to support the failing ventricle. Nevertheless, available devices have been used for cavopulmonary support in patients with failing Fontan circulation [294, 295]. Others use clinically available VADs as a bridge to transplant [296–299]. For patients with failing Fontan circulation, TAH might be a viable option [300]. In cases of failing Fontan circulation and ventricular failure, the BiVAD remains an option but requires revision of the Fontan pathway to allow the separation of the systemic venous and pulmonary circulations, which can be very 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