Document Detail


Double-root translocation for double-outlet right ventricle with noncommitted ventricular septal defect or double-outlet right ventricle with subpulmonary ventricular septal defect associated with pulmonary stenosis: an optimized solution.
MedLine Citation:
PMID:  20417745     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Biventricular repair of double-outlet right ventricle (DORV) with noncommitted ventricular septal defect (VSD) or subpulmonary VSD, associated with pulmonary stenosis, remains controversial. The usual technique, Rastelli or r?paration ? l'?tage ventriculaire (REV) procedure, may not meet a perfect biventricular outflow tract reconstruction in terms of hemodynamic performance and long-term outcome. Here we present an early result of an alternative solution for these anomalies by double-root translocation technique. METHODS: Between August 2006 and August 2009, a total of 10 consecutive patients underwent a double-root translocation procedure, at a median age of 48 +/- 55 months (range, 1 to 16 years). The VSD was repaired with a Dacron patch, and VSD enlargement was done in 3 patients. The aortic translocation was done with (n = 4) or without (n = 6) coronary reimplantation. The neopulmonary artery was reconstructed with a monocusp bovine jugular vein patch (n = 8) or a homograft patch (n = 2). The mean follow-up interval was 21.9 +/- 11 months (range, 2 to 36). Biventricular outflow tract function was assessed by echocardiography. RESULTS: There were no early or late deaths, and no required reoperations. Two patients required early support by extracorporeal membrane oxygenation. Postoperative echocardiography showed satisfactory hemodynamic effect of the reconstructed biventricular outflow tract and ventricular function. One patient had trivial aortic regurgitation and 4 patients had trivial or mild pulmonary insufficiency in follow-up. CONCLUSIONS: The early results showed an optimized solution for DORV with noncommitted VSD or DORV with subpulmonary VSD, associated with pulmonary stenosis. Long-term benefits need to be evaluated with a larger number of patients and longer follow-up.
Authors:
Shengshou Hu; Yongquan Xie; Shoujun Li; Xu Wang; Fuxia Yan; Yongqing Li; Zhongdong Hua; Yan Li
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  89     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-26     Completed Date:  2010-06-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1360-5     Citation Subset:  AIM; IM    
Copyright Information:
Copyright (c) 2010 The Society of Thoxracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Cardiovascular Surgery Department, Fuwai Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China. shengshouhu@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Abnormalities, Multiple / surgery*,  ultrasonography
Adolescent
Cardiac Surgical Procedures / methods*
Cardiopulmonary Bypass / methods
Child
Child, Preschool
Cohort Studies
Double Outlet Right Ventricle / complications,  surgery*,  ultrasonography
Echocardiography, Doppler
Extracorporeal Membrane Oxygenation / methods
Female
Follow-Up Studies
Heart Defects, Congenital / surgery,  ultrasonography
Heart Septal Defects, Ventricular / complications,  surgery*,  ultrasonography
Humans
Infant
Male
Pulmonary Artery / surgery
Pulmonary Valve Stenosis / complications,  surgery*,  ultrasonography
Retrospective Studies
Risk Assessment
Treatment Outcome
Ventricular Function, Left / physiology
Comments/Corrections
Comment In:
Ann Thorac Surg. 2010 May;89(5):1365   [PMID:  20417746 ]

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


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