BCPS, bidirectional cavopulmonary shunt; TCPC, total cavopulmonary connection; mPAP, mean pulmonary artery pressure; PCWP, pulmonary capillary wedge pressure, PVRI, pulmonary vascular resistance index. If the score of children who can achieve biventricular repair in non-invasive assessment is >8 points, and the score of children who can achieve univentricular repair is >6 points, they are considered high-risk surgical candidates. These children are more likely to develop reactive pulmonary hypertension and pulmonary hypertensive crises during the perioperative period. It is recommended that these children undergo cardiac catheterization before surgery.

Children with a cardiac catheterization score ≥8 points are not recommended for radical surgery. For children undergoing univentricular repair, achieving Fontan circulation is crucial, and normal or even lower than normal pulmonary vascular resistance is key to surgical success. Children with a cardiac catheterization score ≤4 points can be followed up if ≤6 months, and BCPS or TCPC surgery can be performed if >6 months. Children with a score of 5-7 points are recommended to undergo pulmonary artery banding to protect the pulmonary vessels, with follow-up every 3 months. Based on the follow-up results, it will be decided whether BCPS or TCPC surgery is needed. Children with a score >8 points are currently not considered for BCPS or TCPC surgery.