Biventricular repair for aortic atresia or hypoplasia and ventricular septal defect

Autor: Caren S. Goldberg, Richard G. Ohye, Edward L. Bove, Ralph S. Mosca, Lisa A. Lee, Koji Kagisaki
Jazyk: angličtina
Předmět:
Heart Septal Defects
Ventricular
Male
Pulmonary and Respiratory Medicine
Aortic valve
medicine.medical_specialty
congenital
hereditary
and neonatal diseases and abnormalities
Heart Ventricles
Transposition of Great Vessels
medicine.medical_treatment
Dextrocardia
Pulmonary Artery
Aortic Coarctation
Aortopulmonary window
Blood Vessel Prosthesis Implantation
Actuarial Analysis
Aortic Valve Atresia
Cause of Death
Internal medicine
Mitral valve
medicine
Humans
Surgical Wound Infection
cardiovascular diseases
Cardiac Surgical Procedures
Aorta
business.industry
Anastomosis
Surgical
Interrupted aortic arch
Infant
Newborn
Infant
medicine.disease
Echocardiography
Doppler
Hypoplasia
Surgery
Survival Rate
Treatment Outcome
medicine.anatomical_structure
Aortic Valve
Atresia
Cardiology
cardiovascular system
Female
Norwood procedure
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
Zdroj: The Journal of Thoracic and Cardiovascular Surgery. (4):648-654
ISSN: 0022-5223
DOI: 10.1016/S0022-5223(99)70010-3
Popis: Objective: Aortic valve atresia or hypoplasia can present with a ventricular septal defect and a normal mitral valve and left ventricle. These patients may be suitable for biventricular repair, although the optimal initial management strategy remains unknown. Methods: From January 1991 through March 1999, 20 patients with aortic atresia or hypoplasia and ventricular septal defect underwent operation with the intent to achieve biventricular repair. Aortic atresia was present in 7 patients, and aortic valve hypoplasia was present in 13 patients. Among those patients with aortic hypoplasia, Z-scores of the aortic valve anulus ranged from –8.8 to –2.7. Associated anomalies included interrupted aortic arch (n = 12 patients), coarctation (n = 6 patients), aortopulmonary window (n = 1 patient), and heterotaxia (n = 1 patient). Nine patients were staged with an initial Norwood procedure followed by biventricular repair in 8 patients. One patient awaits biventricular repair after a Norwood procedure. The conditions of 11 patients were corrected with a single procedure. Results: Among the 9 patients who underwent staged repair, there were no deaths after the Norwood procedure and 1 death after biventricular repair. For the 11 patients who underwent a primary biventricular repair, there was 1 early death and 2 late deaths from noncardiac causes. Follow-up ranged from 1 to 85 months (mean, 28 months). Actuarial survival for the entire group was 78% ± 10% at 5 years and was not significantly different between staged repair (89%) and primary biventricular repair (73%). Conclusions: Both primary and staged biventricular repair for patients with aortic atresia or hypoplasia and ventricular septal defect may be performed with good late survival. Refinements in technique of conduit insertion and arch reconstruction have resulted in primary biventricular repair becoming our preferred approach. (J Thorac Cardiovasc Surg 1999;118:648-54)
Databáze: OpenAIRE
Externí odkaz: