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Intermediate-term results of the Senning or Mustard procedures combined with the Rastelli operation for patients with discordant atrioventricular connections associated with discordant ventriculoarterial connections or double outlet right ventricle.
Cardiol Young. 2007 Apr; 17(2):158-65.CY

Abstract

BACKGROUND

In patients with discordant atrioventricular and ventriculoarterial connections, anatomic repair restores the morphologically left ventricle to its role in supporting the systemic circulation. In this study, we have evaluated the outcomes in the intermediate term for this complex surgical procedure.

METHODS

Between December 1984 and October 2003, 4 patients underwent an atrial switch operation concomitantly with a Rastelli operation, and 2 patients underwent an atrial switch operation and a patch-plasty of the pulmonary outflow tract for anatomic repair at a mean age of 3.3 plus or minus 2.1 years. All patients had intracardiac rerouting, connecting the morphologically left ventricle to the aorta.

RESULTS

There were no hospital deaths. In 5 patients, reoperation was needed, either for baffle complications, exchange of the conduit, repair of a residual ventricular septal defect, or relief of obstruction within the left ventricular outflow tract. Death occurred in 1 patient, from cardiac failure 6 months after correction. Mean follow-up time was 6.5 plus or minus 6.4 years, with a range from 6 months to 17 years. At follow-up, 1 patient presented with moderate tricuspid insufficiency, and 1 patient with mild obstruction of the pulmonary venous pathway. The remaining 3 patients showed good left and right ventricular function, and no, or mild tricuspid and mitral insufficiency.

CONCLUSIONS

Anatomic repair can be performed with low hospital mortality. Restoration of the morphologically left ventricle into the systemic circulation in patients with discordant atrioventricular and ventriculoarterial connections is a demanding approach, associated with various reoperations over time. Despite this, the approach seems to be an appropriate solution for selected patients, since the majority of the patients show good left and right ventricular function, and no, or mild tricuspid and mitral insufficiency up to 17 years after correction.

Authors+Show Affiliations

Department of Cardiovascular Surgery, German Heart Centre Munich at the Technical University, Munich, Germany. hoerer@dhm.mhn.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17244378

Citation

Hörer, Jürgen, et al. "Intermediate-term Results of the Senning or Mustard Procedures Combined With the Rastelli Operation for Patients With Discordant Atrioventricular Connections Associated With Discordant Ventriculoarterial Connections or Double Outlet Right Ventricle." Cardiology in the Young, vol. 17, no. 2, 2007, pp. 158-65.
Hörer J, Haas F, Cleuziou J, et al. Intermediate-term results of the Senning or Mustard procedures combined with the Rastelli operation for patients with discordant atrioventricular connections associated with discordant ventriculoarterial connections or double outlet right ventricle. Cardiol Young. 2007;17(2):158-65.
Hörer, J., Haas, F., Cleuziou, J., Schreiber, C., Kostolny, M., Vogt, M., Holper, K., & Lange, R. (2007). Intermediate-term results of the Senning or Mustard procedures combined with the Rastelli operation for patients with discordant atrioventricular connections associated with discordant ventriculoarterial connections or double outlet right ventricle. Cardiology in the Young, 17(2), 158-65.
Hörer J, et al. Intermediate-term Results of the Senning or Mustard Procedures Combined With the Rastelli Operation for Patients With Discordant Atrioventricular Connections Associated With Discordant Ventriculoarterial Connections or Double Outlet Right Ventricle. Cardiol Young. 2007;17(2):158-65. PubMed PMID: 17244378.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intermediate-term results of the Senning or Mustard procedures combined with the Rastelli operation for patients with discordant atrioventricular connections associated with discordant ventriculoarterial connections or double outlet right ventricle. AU - Hörer,Jürgen, AU - Haas,Felix, AU - Cleuziou,Julie, AU - Schreiber,Christian, AU - Kostolny,Martin, AU - Vogt,Manfred, AU - Holper,Klaus, AU - Lange,Rüdiger, Y1 - 2007/01/23/ PY - 2006/03/24/accepted PY - 2007/1/25/pubmed PY - 2007/8/22/medline PY - 2007/1/25/entrez SP - 158 EP - 65 JF - Cardiology in the young JO - Cardiol Young VL - 17 IS - 2 N2 - BACKGROUND: In patients with discordant atrioventricular and ventriculoarterial connections, anatomic repair restores the morphologically left ventricle to its role in supporting the systemic circulation. In this study, we have evaluated the outcomes in the intermediate term for this complex surgical procedure. METHODS: Between December 1984 and October 2003, 4 patients underwent an atrial switch operation concomitantly with a Rastelli operation, and 2 patients underwent an atrial switch operation and a patch-plasty of the pulmonary outflow tract for anatomic repair at a mean age of 3.3 plus or minus 2.1 years. All patients had intracardiac rerouting, connecting the morphologically left ventricle to the aorta. RESULTS: There were no hospital deaths. In 5 patients, reoperation was needed, either for baffle complications, exchange of the conduit, repair of a residual ventricular septal defect, or relief of obstruction within the left ventricular outflow tract. Death occurred in 1 patient, from cardiac failure 6 months after correction. Mean follow-up time was 6.5 plus or minus 6.4 years, with a range from 6 months to 17 years. At follow-up, 1 patient presented with moderate tricuspid insufficiency, and 1 patient with mild obstruction of the pulmonary venous pathway. The remaining 3 patients showed good left and right ventricular function, and no, or mild tricuspid and mitral insufficiency. CONCLUSIONS: Anatomic repair can be performed with low hospital mortality. Restoration of the morphologically left ventricle into the systemic circulation in patients with discordant atrioventricular and ventriculoarterial connections is a demanding approach, associated with various reoperations over time. Despite this, the approach seems to be an appropriate solution for selected patients, since the majority of the patients show good left and right ventricular function, and no, or mild tricuspid and mitral insufficiency up to 17 years after correction. SN - 1047-9511 UR - https://www.unboundmedicine.com/medline/citation/17244378/Intermediate_term_results_of_the_Senning_or_Mustard_procedures_combined_with_the_Rastelli_operation_for_patients_with_discordant_atrioventricular_connections_associated_with_discordant_ventriculoarterial_connections_or_double_outlet_right_ventricle_ L2 - https://www.cambridge.org/core/product/identifier/S1047951107000121/type/journal_article DB - PRIME DP - Unbound Medicine ER -