My daughter has LTGA, PA, a Large VSD, PFO or small ASD and dextracardia. She currently has the Glenn anatomy as her surgeon has her on the one ventricle path due to her dextracardia and his feeling that the a conduit used in the rastelli could cause issues. We have since recieved a second opinion saying she is at a low risk for a biventricle repair. I have don't some research on the Senning/Rastelli and it seems that even though she would have a physiologically normal heart it may in fact not be all that much better in the short and long term then the fontan for complex LTGAers. Want are your thoughts?
Your raise a very good point: is it wiser to do a less complicated operation (Fontan- single ventricle) in a person with 2 normal ventricles or to do a more complicated operation in order to have the person use the 2 ventricles. There are obviously complications with both types of surgery, in the short and long terms. Unfortunately, the ability to do a 2 ventricle repair in your daughter's complex situation is highly individualized and cannot be commented upon accurately here as to which choice is better in your case. Under any circumstance, when a Senning/Rastelli is done in childhood, there will always be the need for future surgery to replace the pulmonary conduit, so that also has to be taken into consideration. And both operations (Fontan and Senning/Rastelli) have the potential for long term arrhythmias and pacemaker placement.
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