The Annals of thoracic surgery
The Society of Thoracic Surgeons (2026) Expert Consensus Document on Management of Borderline Left Heart Excluding Unbalanced Atrioventricular Septal Defect and Strategies for Biventricular Conversion
By Karamlou T, Woo JL, Lam CZ and 12 others.
Abstract
Background
Strategies to recruit the left ventricle in borderline left heart (BLH), whether utilizing primary or staged recruitment strategy, are challenged by lack of consensus regarding optimal substrate, timing, and technique.
Methods
A panel of experienced congenital cardiac surgeons, cardiologists and imaging experts were convened to develop key questions related to BLH management, excluding unbalanced atrioventricular septal defect, from neonatal period through 1 year, using the PICO (Patients/Population, Intervention, Comparison/Control, Outcome) framework. Literature searches were performed for each question. Using a modified Delphi method, consensus statements were developed.