Pediatric Cardiology

, Volume 38, Issue 7, pp 1519–1521 | Cite as

Critically Underdeveloped Left Heart Morphology Associated with Prematurity and Low Birth Weight: Conditional Staged Rehabilitation Towards Biventricular Repair and Time-Related Growth of Left Heart Structures

  • Fareed Ahmad
  • Robert Mangano
  • Shirah Shore
  • Anastasios Polimenakos
Case Report


This is a case report of premature low birth weight infant with hypoplasia of left heart structures and a large malaligned VSD who underwent successful staged approach of biventricular repair. We obtained qualitative and quantitative echocardiographic, MRI, and conventional catheterization data to support stepwise strategy towards LV rehabilitation to sustain adequate cardiac output. A thorough and intense follow-up has shown significant growth of left heart structures and favorable clinical status following staged biventricular repair. Our data indicate usefulness of qualitative and quantitative advanced complimentary multi-imaging modalities in predicting the postnatal growth potential of critically underdeveloped left heart structures.


Hypoplastic left ventricle Volumetric analysis Congenital 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.


  1. 1.
    Schwart Marcy L, Gauvreau Kimberlee, Geva Tal et al (2001) Predictors of outcome biventricular repair in infants with multiple left heart obstructive lesions. Circulation 104:682–687CrossRefGoogle Scholar
  2. 2.
    Nakamura Yuki, Hagino Ikuo, Nakajima Hiromichi, Aoki Mitsuru et al (2015) Staged biventricular repair-oriented strategy in borderline biventricular repair candidates with ventricular septal defect. Pediatr Cardiol 36(8):1712–1721CrossRefPubMedGoogle Scholar
  3. 3.
    Tchervenkov Christo I et al (2004) Indications, criterions, and principles for biventricular repair. Cardiol Young 14(S1):97–100CrossRefPubMedGoogle Scholar
  4. 4.
    Hickey EJ, Caldarone CA, Blackstone EH et al (2007) Critical left ventricular outflow tract obstruction: the disproportionate impact of biventricular repair in borderline cases. J Thorac Cardiovasc Surg 134:1429–1436CrossRefPubMedGoogle Scholar
  5. 5.
    Grosse-Wortmann L, Yun T, Al-Radi O, Kim S, Nii M, Lee KJ et al (2008) Borderline hypoplasia of the left ventricle in neonates: insights for decision-making from functional assessment with magnetic resonance imaging. J Thorac Cardiovasc Surg 136:1429–1436CrossRefPubMedGoogle Scholar
  6. 6.
    Kaplinski Michelle, Cohen Mary S et al (2015) Characterising adequacy or inadequacy of the borderline left ventricle: what tools can we use? Heart week 25(8):1482–1488Google Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Fareed Ahmad
    • 1
  • Robert Mangano
    • 1
  • Shirah Shore
    • 1
  • Anastasios Polimenakos
    • 1
  1. 1.Janet Weis Children hospitalGeisinger Health SystemDanvilleUSA

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