Document Detail

Biventricular repair of double outlet right ventricle with noncommitted ventricular septal defect.
MedLine Citation:
PMID:  11994877     Owner:  NLM     Status:  MEDLINE    
Double outlet right ventricle (DORV) with noncommitted ventricular septal defect (VSD) (DORVncVSD) represents the most extreme form of DORV, raising challenging surgical difficulties for biventricular repair. The considerable distance between the VSD and the aorta is primarily because of the very abnormal location of the aorta. The definition of DORVncVSD includes: (1) a VSD distant (greater than aortic diameter) from both arterial valves; (2) both great vessels arising fully from the right ventricle; and (3) a double conus. Double outlet right ventricle with noncommitted ventricular septal defect is a primitive right ventricle, as seen during embryologic development, characterized by the presence of the entire conotruncus from the right ventricle. One surgical technique for repair of DORVncVSD is rerouting of the VSD to the aorta by a long intraventricular tunnel. This technique is limited by the presence of conal tricuspid chordae and by the distance between the tricuspid and pulmonary valves, and is associated with an important risk of subaortic obstruction. Rerouting through the pulmonary artery followed by arterial switch seems a more satisfactory surgical solution. When the VSD is distant from the aorta, it is almost always quite close to the pulmonary artery. Rerouting to the pulmonary artery creates a smaller channel, and its application is not limited by the presence of tricuspid chordae or the tricuspid-to-pulmonary valve distance. However, the arterial switch frequently involves relocating complex coronary arteries.
François Lacour-Gayet
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Seminars in thoracic and cardiovascular surgery. Pediatric cardiac surgery annual     Volume:  5     ISSN:  1092-9126     ISO Abbreviation:  Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu     Publication Date:  2002  
Date Detail:
Created Date:  2002-05-07     Completed Date:  2004-02-24     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  9815944     Medline TA:  Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu     Country:  United States    
Other Details:
Languages:  eng     Pagination:  163-72     Citation Subset:  IM    
Copyright Information:
Copyright 2002 by W.B. Saunders Company
Department of Cardiac Surgery, Eppendorf University Hospital, Hamburg, Germany.
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MeSH Terms
Cardiac Surgical Procedures / methods*
Diagnosis, Differential
Double Outlet Right Ventricle / diagnosis,  surgery*
Heart Septal Defects, Ventricular / diagnosis,  surgery*
Heart Ventricles / embryology,  surgery
Palliative Care

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

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