For neonates with severe left ventricular outflow tract obstruction the initial clinical decision for
either biventricular (BVR) or univentricular repair (UVR) is absolutely critical.
The Univentricular Survival Advantage Prediction tool (UVR-SA) is a regression model that calculates
the predicted 5-year survival advantage by pursuing Univentricular Repair (UVR) versus Biventricular
Repair (BVR) in critical left ventricular outflow tract (LVOT) obstruction.
The tool was developed on children with the full spectrum of critical LVOT obstruction and varying
degrees of LV hypoplasia. However, aortic and mitral valve patency, atrioventricular concordance,
ventriculoarterial concordance and continuity of the aortic arch are all necessary pre-requisites
to its use. In addition, the model only applies to infants with critical LVOT obstruction (and
not, for example, coarctation with secondary LV hypoplasia).
Interpretation:
If the UVR-SA value is zero, then neither UVR nor BVR is favoured over the other.
If the UVR-SA value is positive, then survival is predicted to be better with UVR.
If the UVR-SA value is negative, then survival is predicted to be better with BVR.
The magnitude of the score represents the difference in predicted 5-year survival between UVR and BVR.
As an example, if 5-year survival was predicted to be 75% for UVR and 60% for BVR, then the UVR-SA
would be +15. Alternatively, if 5-year survival was predicted to be 72% for UVR and 80% for BVR,
then the UVR-SA would be -8.
By filling in this form and clicking 'I Agree' you are consenting to allow us to store the information which
you enter into the forms into a database. We ask that you save patients actual data and not various "what if"
scenarios. Confidentiality for the patient, physician, and institution is ensured as we will not release the
entered data to anyone without your prior consent. If you agree we will use your email address to periodically
contact you to find out what management path was ultimately chosen and the patient's subsequent status;
thereby assisting in the validation of our model.
DISCLAIMER: The UVR-SA tool provided at www.chssdc.org is presented for the purpose of assisting cardiovascular
congenital surgeons and paediatric cardiologists in dealing with critical aortic stenosis in neonates. Nothing
contained on this site is intended to be instructional for medical diagnosis or treatment. The information
the calculator provides should not be relied as a replacement for sound clinical judgement nor should it be
used in place of a clinical examination. Do not disregard medical advice you have received on the basis of what
you have read at this site and do not delay in seeking such advice. Always consult with experts in critical
aortic stenosis before embarking on a new treatment for your patients.
