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Treatment for Your Child’s Hypoplastic Ventricle: Stage II

Front view cross section of heart showing atria on top and ventricles on bottom showing aorta, pulmonary artery, mitral valve, aortic valve, left atrium, left ventricle, right atrium, right ventricle, tricuspid valve, pulmonary valve, superior vena cava, and inferior vena cava. Arrows on right side of heart show oxygen-poor blood pumping to lungs. Arrows on left side of heart show oxygen-rich blood pumped to body.
In a normal heart, oxygen-poor blood is pumped to the lungs from the right ventricle. Oxygen-rich blood is pumped to the body from the left ventricle.

Your child has a heart problem that includes a hypoplastic ventricle. This means that one of the ventricles is either too small or is absent. The most common treatment for this problem is heart surgery. This is often done in 3 stages. This sheet explains what is done during the second stage (stage II). The surgery cannot repair your child’s heart problem. But it can help relieve your child’s symptoms. It may also increase your child’s chances of living a more normal life. The doctor can answer your questions and tell you more as needed.

The Goals of Heart Surgery for a Hypoplastic Ventricle

  • Stage I. Make the single working ventricle the main pumping chamber of the heart, providing blood to both the lungs and the body. 

  • Stage II. Decrease the workload of the single ventricle, and reduce the mixing of oxygen-poor and oxygen-rich blood. 

  • Stage III. Separate the circulation of blood in the heart so that there is very little mixing of oxygen-rich and oxygen-poor blood .

Risks and Possible Complications of Heart Surgery Include

  • Arrhythmia (abnormal heart rhythm)

  • Problems in the lungs

  • Infection

  • Bleeding

  • Problems with the nervous system, such as seizure of stroke

  • Abnormal buildup of fluid around the heart or lungs

Stage II: The Bidirectional Glenn (BDG) Procedure

Front view cross section of heart showing bidirectional Glenn procedure for hypoplastic left ventricle. Superior vena cava is connected to pulmonary artery. Arrows show blood flowing from left atrium to right ventricle and mixing with blood from inferior vena cava, then being pumped out aorta.
The BDG procedure sends oxygen-poor blood returning from the upper body directly to the lungs. This helps decrease the workload of the single ventricle.

The second stage of the surgery is called the BDG procedure. It is most often done when a child is 3 to 6 months old. A hospital stay of 5 to 7 days may be needed. The procedure provides low-pressure blood flow to the lungs. And it helps reduce the workload of the single ventricle. During the surgery, the surgeon:

  • Separates the superior vena cava (SVC) from the heart. The SVC is the large blood vessel that brings oxygen-poor blood from the upper body to the right atrium. This blood vessel is cut from the right atrium. The end closest to the right atrium is closed off. The other end is sewn to the pulmonary artery. This allows oxygen-poor blood from the upper body to flow directly to the lungs, without passing through the heart. There, it receives oxygen.

  • Removes any additional source of blood flow to the pulmonary artery. If a shunt, band, or other device was placed during a previous procedure to direct blood to the lungs, it is removed at this time.

When to Call the Doctor

Call the doctor right away if your child has any of the following:

  • Increased redness, draining, swelling, or bleeding at the incision site

  • Fever 100.4°F (38°C) or higher

  • Trouble feeding, poor appetite, or poor weight gain

  • Irritability

  • Belly pain

  • Tiredness

  • Shortness of breath or trouble breathing

  • Cough that won’t go away

  • Nausea or vomiting that continues

  • Irregular heartbeat

  • No noticeable improvement

Online Medical Reviewer: Bass, Pat F. III, MD, MPH
Online Medical Reviewer: MMI board-certified, academically affiliated clinician
Last Review Date: 2/15/2014
© 2000-2014 Krames StayWell, 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.