double outlet right ventricle

But I think if I had one take-home message, it's that there is some very low-lying fruit that is oftentimes being, being neglected.

And so that would be, like, double outlet right ventricle with the remote VSD, [clears throat] uh, mildly unbalanced canals, um, and, um, you know, any sort of DORV, any, really any sort of double outlet right ventricle, um, remote aortas, congenitally corrected transposition.

Any patient where you look at the echo and you see two decent-sized ventricles should probably get a 2V repair, I think.

And those kids are out there.

I think, uh, the basic philosophy should be every patient undergoing single ventricle palliation, the question should be asked: Can a biventricular repair be undertaken at each stage? Ideally not waiting until the Fontan.

And at, a- and also, uh, having that as a programmatic approach when you discuss your patients at weekly conference or whenever, I think that should come up as a point and be, uh, reiterated again and again.

And I still remember the first conversation Dr. Anderson and I had when he started the program, and we said, "If we're gonna succeed, we need to start with the low-hanging fruit that he describes," right? So we started with hypoplastic right ventricles and the DORVs with mildly unbalanced canals, with remote VSDs.

And I think that strategy with the initial success in the program was very helpful to convince the skeptics in the program in our institution to say, "Hey, no, this is working.