Single ventricle circulation, characterized at birth by a rudimentary or absent left or right ventricle, presents a challenging and life-threatening physiological scenario. Surgical palliation aims to restore the balance between systemic and pulmonary blood flow and is staged, each of the three stages presenting the surgeon with different options:
- Stage 1 (Norwood procedure) involves different types of shunting to source pulmonary blood flow, or recently a hybrid approach ;
- Stage 2 can involve a superior cavopulmonary connection (Glenn operation) or patching between the right atrium and the pulmonary arteries (Hemi Fontan operation );
- Stage 3 involves a total cavopulmonary connection with extracardiac conduit or lateral tunnel, or with novel alternatives such as the Y-graft .