Treatment algorithm for Pulmonary Atresia with Intact Ventricular Septum

The articles in this issue reveal the complexity of the PAIVS spectrum and the methods of treatment that are currently being used. Despite the complexity, the articles provide greater understanding of the developmental events leading to these lesions and the methods that could be used to reverse them. Taken together, the evidence certainly favors embarking on a 2VR track whenever possible. The number of completed biventricular repairs will be increased and also the adverse later consequences of a hypertensive RV and persisting significant RV to coronary artery connections will be eliminated when they are not. The algorithm, therefore, is heavily weighted to 2VRs.