Treatment for Your Child’s Hypoplastic Ventricle: Stage II
hypoplastic left heart syndrome (HLHS), the left side of the heart can't pump blood to the
rest of the body. The right ventricle pumps the blood into the pulmonary artery. Blood
reaches the aorta through a patent ductus arteriosus, patent foramen ovale, or an atrial
septal defect. A connection between the right and left side of the heart is key for
child has a heart problem that includes a hypoplastic ventricle. This means that 1 of the
ventricles is either too small or is not there. 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 can't fix your child’s heart problem. But it can
help ease your child’s symptoms. It may increase your child’s chances of living a more
normal life. The healthcare provider can answer your questions and tell you more as
The goals of heart surgery for a hypoplastic ventricle
Stage I. Make the 1 working ventricle the main pumping chamber of the
heart, sending blood to both the lungs and the body.
Stage II. Decrease the workload of the single ventricle. Reduce the mixing
of oxygen-poor and oxygen-rich blood.
Stage III. Separate the circulation of blood in the heart. This is so
there is very little mixing of oxygen-rich and oxygen-poor blood.
What are the risks?
Heart rhythm problem (arrhythmia)
Problems in the lungs
Problems with the nervous system, such as seizures or stroke
Abnormal buildup of fluid around the heart or lungs
Stage II: The bidirectional Glenn (BDG) procedure
second stage of the surgery is called the BDG procedure. It is most often done when a
child is 3 to 6 months old. Your child may need to stay in the hospital for 5 to 7 days.
The procedure gives low-pressure blood flow to the lungs. And it helps reduce the
workload of the 1 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 right pulmonary artery.
This lets oxygen-poor blood from the upper body flow right to the lungs. It does
not pass through the heart. In the lungs, the blood picks up oxygen.
Removes any other source of blood flow to the pulmonary artery. If a
shunt, band, or other device was placed during a past procedure to direct blood to
the lungs, it is removed at this time.
Fixes any other areas with problems. For example, the narrowing of the
aorta done in stage I can be fixed.
When to call your child's healthcare provider
Call your child's healthcare provider right away if any of these occur:
Redness, draining, swelling, or bleeding at the incision site that gets worse
Swelling of the head and neck that gets worse
Skin, lips, or nails that look blue (cyanosis)
Fever of 100.4°F (38°C) or higher, or as directed by your child's provider
Trouble feeding, poor appetite, or poor weight gain
Shortness of breath or trouble breathing
Cough that won’t go away
Nausea or vomiting that continues
No clear improvement