Complex Reconfiguring of the Heart Through Septation and/or Intracardiac Baffles

In complex biventricular reconstruction, the goal is to redirect blood flow or reorient structures in the heart so that it can function more efficiently. A heart naturally has two inflows, two pumping chambers (the two lower ventricles of the heart), and two outflows. With certain congenital heart conditions, the heart is missing one or more of these elements, they are connected to each other in the wrong way, or they are in the wrong position. Some individuals have multiple heart anomalies that can be repaired simultaneously with these types of complex biventricular reconstruction.

Septation is the reconstruction of the heart into separate pumping chambers by adding material to create a wall within the heart. This term is commonly used when converting a single pump into a dual pump for patients with single-ventricle-type congenital heart disease.

Intracardiac baffle often goes along with septation. Baffles are structures that direct the flow of something—in this case, blood. In the heart, baffles are created with artificial material to separate the sides of the heart or to lead the blood down a desired pathway, helping to reroute it to where it needs to go.

Septation and/or intracardiac baffles (complex biventricular reconstruction) are used for the following conditions or combinations of conditions:

  • Double outlet right ventricle (DORV). DORV is a rare congenital heart defect where the pulmonary artery and the aorta both come from the right side of the heart, or ventricle, rather than the aorta coming from the left ventricle. Some complex forms of DORV are very difficult to surgically separate into two pumps, each with its own outflow, as in the normal heart.
  • Other conotruncal defects (structural defects of the outflow tract) with remote ventricular septal defect (VSD). In VSD, a common heart defect, there is a hole in the wall that separates the left and right ventricles. However, when a VSD is remote, it is not near a major artery and can often make separating the blood flow of the right and left sides of the heart challenging.