Staged Heart Septation

Also known as: staged ventricular septation

What is a staged heart septation?

Staged heart septation, also known as staged ventricular septation, is a surgical approach used to treat selected children with complex congenital heart defects, particularly those with a double-inlet left ventricle (DILV) or double-inlet right ventricle (DIRV). It is called “staged” because the repair is performed through a series of operations during the first years of life. The goal is to gradually create two functional pumping chambers and achieve a circulation that more closely resembles that of a normal heart, improving long-term health and quality of life.

What happens during the procedure?

Each stage of ventricular septation is a major operation performed under general anesthesia. The goal is to gradually remodel the heart and create two ventricles capable of supporting a biventricular circulation.

The three stages are typically as follows:

Stage 1 – Initial Palliation (4–6 months). The pulmonary artery is banded to control blood flow to the lungs and promote favorable ventricular remodeling.
Stage 2 – Partial Septation (4–6 months or later). A patch is used to begin dividing the single ventricular chamber into two ventricles, often leaving an opening (VSD) to help balance pressures during healing.
Stage 3 – Complete Repair (2–3 years). The remaining openings are closed and the pulmonary artery band is removed, completing the separation of the ventricles and establishing a biventricular circulation.

Is any special preparation needed?

Your child will likely undergo several diagnostic tests to determine whether staged ventricular septation is the most appropriate treatment option. Your medical team will provide specific instructions regarding medications, feeding, and preparation before each procedure.

What are the risk factors?

Staged ventricular septation involves a series of complex heart operations and, like all major cardiac procedures, carries important risks. Your child's medical team will discuss these risks and expected outcomes with you in detail. Despite these challenges, for selected patients this approach may offer the opportunity to achieve a biventricular circulation and avoid lifelong single-ventricle physiology. Many children who undergo successful staged ventricular septation go on to attend school, participate in normal childhood activities, and enjoy a good quality of life.

Reviewed by: David Kalfa, MD

This page was last updated on: June 25, 2026 04:07 PM

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Double Inlet Left Ventricle

Normally the right atrium is connected to the right ventricle which pumps oxygen-poor blood from the body tissues, out to the lungs to get oxygen. The left atrium collects the oxygenated blood from the lungs and is connected to the left ventricle which pumps the oxygen-rich blood out to the body. In double inlet left ventricle, both atria connect to one ventricle and the right ventricle is small.