Document Detail


Biventricular repair for aortic atresia or hypoplasia and ventricular septal defect.
MedLine Citation:
PMID:  10504629     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
R G Ohye; K Kagisaki; L A Lee; R S Mosca; C S Goldberg; E L Bove
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  118     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  1999 Oct 
Date Detail:
Created Date:  1999-11-30     Completed Date:  1999-11-30     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  648-53     Citation Subset:  AIM; IM    
Affiliation:
Division of Pediatric Cardiovascular Surgery, Section of Cardiac Surgery, C.S. Mott Children's Hospital, University of Michigan School of Medicine, Ann Arbor, USA.
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MeSH Terms
Descriptor/Qualifier:
Actuarial Analysis
Anastomosis, Surgical / adverse effects
Aorta / abnormalities
Aortic Coarctation / complications
Aortic Valve / abnormalities*,  surgery
Blood Vessel Prosthesis Implantation / adverse effects
Cardiac Surgical Procedures / adverse effects
Cause of Death
Dextrocardia / complications
Echocardiography, Doppler
Female
Follow-Up Studies
Heart Septal Defects, Ventricular / surgery*
Heart Ventricles / surgery
Humans
Infant
Infant, Newborn
Male
Pulmonary Artery / abnormalities
Surgical Wound Infection / etiology
Survival Rate
Transposition of Great Vessels / complications
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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