| Biventricular repair for right atrial isomerism. | |
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MedLine Citation:
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PMID: 16631677 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Biventricular repair is often difficult to accomplish in patients with right atrial isomerism because of complex anomalous structures. METHODS: Ten patients with right atrial isomerism underwent biventricular repair. Their ages ranged from 15 months to 21 years. The follow-up period ranged from 1 month to 21 years. The Fontan procedure was unsuitable in 7 patients. The atrioventricular valves were separated in 5 patients and common in 5. One patient who had severe right-sided atrioventricular valvular regurgitation required concomitant prosthetic valve replacement. Another patient with a hypoplastic intraventricular septum underwent ventricular septation. Nine patients had two balanced ventricles. A ventricular septal defect was enlarged for rerouting in 3 patients. All patients had anomalous venoatrial connections and required intra-atrial baffle rerouting. One with major aortopulmonary collateral arteries underwent staged unifocalization. Three had extracardiac conduit repair. The outcomes were compared with 97 patients who underwent the Fontan procedure. RESULTS: There were 3 early deaths and 1 late death. Six survivors are in New York Heart Association functional class I or II. Two are free from medications. Two required reoperation owing to infection or prosthetic valve failure. At 1 year, cardiac index and systemic venous pressure were 3.2 +/- 0.9 L.min(-1).m(-2) and 6.6 +/- 1.6 mm Hg, respectively. There were no significant differences in survival, freedom from arrhythmia, freedom from reoperation, or exercise tolerance between biventricular repair and the Fontan procedure. CONCLUSIONS: Biventricular repair provided good long-term outcomes in patients with right atrial isomerism. In selected circumstances, biventricular repair is an acceptable alternative to the Fontan procedure. |
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Authors:
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Masahiro Koh; Toshikatsu Yagihara; Hideki Uemura; Koji Kagisaki; Ikuo Hagino; Toru Ishizaka; Soichiro Kitamura |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 81 ISSN: 1552-6259 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 2006 May |
Date Detail:
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Created Date: 2006-04-24 Completed Date: 2006-05-25 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: Netherlands |
Other Details:
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Languages: eng Pagination: 1808-16; discussion 1816 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Abnormalities, Multiple
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surgery* Adolescent Adult Arrhythmias, Cardiac / epidemiology Cardiac Surgical Procedures / methods* Child Child, Preschool Exercise Tolerance Fontan Procedure Heart Atria / abnormalities* Heart Catheterization Heart Ventricles / abnormalities* Humans Infant Pulmonary Artery / surgery Pulmonary Veins / abnormalities Reoperation Viscera / abnormalities |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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