Document Detail


Biventricular repair for double-outlet right ventricle. Results and long-term follow-up.
MedLine Citation:
PMID:  9852927     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The purpose of the present study was to define the optimal management and to identify the risk factors for death and repeat operation in patients with double-outlet right ventricle. METHODS AND RESULTS: From 1985 through 1996, 154 consecutive patients underwent biventricular repair for double-outlet right ventricle. The presence of bilateral infundibular structures was the major inclusion criteria (142 patients). According to the relationship of the ventricular septal defect (VSD) to the great arteries, there were 86 patients with a subaortic VSD (56%), 45 patients with a subpulmonary VSD (29%), 18 patients with a noncommitted VSD (12%), and 5 patients with a doubly committed VSD (3%). Sixty-five patients (42%) had undergone previous palliative procedures. At repair, the median age was 10 months, and the median weight was 6.5 kg. Two main types of repair were used: intraventricular baffle repair (n = 115) and arterial switch operation with VSD-to-pulmonary artery baffle (n = 39). There were 14 hospital deaths (9%; 70% confidence limit [CL], 7% to 12%). The only significant risk factor for early death was the presence of congenital mitral valve anomalies (P = 0.02). Twenty-eight patients (18%) required 39 repeat operations. The repeat operation rate was higher in patients with associated VSD enlargement at baffle construction (n = 29; 19%) (P = 0.01). There were 6 late deaths (4%; 70% CL, 2% to 7%). Patients presenting with pulmonary stenosis constituted a low-risk group for global death (P = 0.008). The median follow-up was 52 months. Ten-year actuarial survival and survival with freedom from repeat operation rates were 86% and 62% (70% CL, 83% to 89% and 54% to 70%), respectively. CONCLUSIONS: Long-term survival with good quality of life can be achieved after either 1- or 2-stage repair of this complex anomaly.
Authors:
E Belli; A Serraf; F Lacour-Gayet; S Prodan; D Piot; J Losay; J Petit; J Bruniaux; C Planché
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation     Volume:  98     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1998 Nov 
Date Detail:
Created Date:  1999-01-08     Completed Date:  1999-01-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  II360-5; discussion II365-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatric Cardiac Surgery, Marie Lannelongue Hospital, University Paris-Sud, Le Plessis-Robinson, France.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Cardiac Surgical Procedures*
Child
Child, Preschool
Double Outlet Right Ventricle / mortality,  physiopathology,  surgery*
Follow-Up Studies
Heart Septal Defects, Ventricular / complications
Heart Ventricles
Humans
Infant
Infant, Newborn
Longitudinal Studies
Mitral Valve / abnormalities
Multivariate Analysis
Reoperation
Risk Factors
Treatment Outcome

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


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