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Biventricular repair for double outlet right ventricle with non-committed ventricular septal defect.
Eur J Cardiothorac Surg. 2015 Oct; 48(4):580-7; discussion 587.EJ

Abstract

OBJECTIVES

Outcomes of biventricular repair for patients with double outlet right ventricle and non-committed ventricular septal defect (DORVncVSD) are not well defined. We aim to report our experience with biventricular repair of this anomaly in proposing an original surgical management that simplifies the anatomical correction.

METHODS

From January 2005 to December 2013, 75 consecutive patients with DORVncVSD who had undergone biventricular repair in our institution were retrospectively included. The patients were divided into 2 groups: 40 patients in Group A had the ventricular septal defect rerouted to the aorta, and 35 patients in Group B had the ventricular septal defect rerouted to the pulmonary artery. Concomitant tricuspid procedures, conal resection and ventricular septal defect enlargement were used to favour intracardiac tunnel geometry.

RESULTS

Five types of biventricular repair and 16 concomitant procedures were performed. Mean age at biventricular repair was 2.2 ± 2.0 years. There were 6 (8.0%) early deaths and 4 (6.1%) early intracardiac baffle obstructions. During the 4.1 ± 4.0 years follow-up, 3 (4.3%) late deaths occurred with an 87.1% estimated overall survival at 5 years (early deaths included). Six late-onset intracardiac tunnel obstructions were noted and three of them required reoperation. Comparing the 2 groups, Group A patients have more late-onset (6 in Group A vs 0 in Group B, P = 0.026) and overall tunnel obstructions (10 in Group A vs 0 in Group B, P = 0.001). Concomitant tricuspid procedures significantly reduced intracardiac obstruction (0 in 16 vs 10 in 24, P = 0.003) without development of any tricuspid regurgitation and stenosis.

CONCLUSIONS

Using appropriate intracardiac tunnel establishment strategy and techniques, biventricular repair of DORVncVSD is feasible with encouraging outcomes. Concomitant tricuspid procedures can reduce intracardiac tunnel geometry without increase of mortality and morbidity.

Authors+Show Affiliations

Pediatric Cardiac Surgery Center, National Center for Cardiovascular Disease and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, PR China drlishoujun@yahoo.com.Pediatric Cardiac Surgery Center, National Center for Cardiovascular Disease and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, PR China.Pediatric Cardiac Surgery Center, National Center for Cardiovascular Disease and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, PR China.Pediatric Cardiac Surgery Center, National Center for Cardiovascular Disease and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, PR China.Pediatric Cardiac Surgery Center, National Center for Cardiovascular Disease and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, PR China.Pediatric Cardiac Surgery Center, National Center for Cardiovascular Disease and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, PR China.Pediatric Cardiac Surgery Center, National Center for Cardiovascular Disease and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, PR China.Pediatric Cardiac Surgery Center, National Center for Cardiovascular Disease and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, PR China.Pediatric Cardiac Surgery Center, National Center for Cardiovascular Disease and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, PR China.Pediatric Cardiac Surgery Center, National Center for Cardiovascular Disease and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, PR China.Pediatric Cardiac Surgery Center, National Center for Cardiovascular Disease and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, PR China.

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25612745

Citation

Li, Shoujun, et al. "Biventricular Repair for Double Outlet Right Ventricle With Non-committed Ventricular Septal Defect." European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery, vol. 48, no. 4, 2015, pp. 580-7; discussion 587.
Li S, Ma K, Hu S, et al. Biventricular repair for double outlet right ventricle with non-committed ventricular septal defect. Eur J Cardiothorac Surg. 2015;48(4):580-7; discussion 587.
Li, S., Ma, K., Hu, S., Hua, Z., Yan, J., Pang, K., Wang, X., Yan, F., Liu, J., Zhang, S., & Chen, Q. (2015). Biventricular repair for double outlet right ventricle with non-committed ventricular septal defect. European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery, 48(4), 580-7; discussion 587. https://doi.org/10.1093/ejcts/ezu523
Li S, et al. Biventricular Repair for Double Outlet Right Ventricle With Non-committed Ventricular Septal Defect. Eur J Cardiothorac Surg. 2015;48(4):580-7; discussion 587. PubMed PMID: 25612745.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Biventricular repair for double outlet right ventricle with non-committed ventricular septal defect. AU - Li,Shoujun, AU - Ma,Kai, AU - Hu,Shengshou, AU - Hua,Zhongdong, AU - Yan,Jun, AU - Pang,Kunjing, AU - Wang,Xu, AU - Yan,Fuxia, AU - Liu,Jinping, AU - Zhang,Sen, AU - Chen,Qiuming, Y1 - 2015/01/21/ PY - 2014/09/10/received PY - 2014/11/20/accepted PY - 2015/1/24/entrez PY - 2015/1/24/pubmed PY - 2016/6/24/medline KW - Biventricular repair KW - Congenital heart disease KW - Double outlet right ventricle KW - Intracardiac tunnel KW - Non-committed ventricular septal defect SP - 580-7; discussion 587 JF - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery JO - Eur J Cardiothorac Surg VL - 48 IS - 4 N2 - OBJECTIVES: Outcomes of biventricular repair for patients with double outlet right ventricle and non-committed ventricular septal defect (DORVncVSD) are not well defined. We aim to report our experience with biventricular repair of this anomaly in proposing an original surgical management that simplifies the anatomical correction. METHODS: From January 2005 to December 2013, 75 consecutive patients with DORVncVSD who had undergone biventricular repair in our institution were retrospectively included. The patients were divided into 2 groups: 40 patients in Group A had the ventricular septal defect rerouted to the aorta, and 35 patients in Group B had the ventricular septal defect rerouted to the pulmonary artery. Concomitant tricuspid procedures, conal resection and ventricular septal defect enlargement were used to favour intracardiac tunnel geometry. RESULTS: Five types of biventricular repair and 16 concomitant procedures were performed. Mean age at biventricular repair was 2.2 ± 2.0 years. There were 6 (8.0%) early deaths and 4 (6.1%) early intracardiac baffle obstructions. During the 4.1 ± 4.0 years follow-up, 3 (4.3%) late deaths occurred with an 87.1% estimated overall survival at 5 years (early deaths included). Six late-onset intracardiac tunnel obstructions were noted and three of them required reoperation. Comparing the 2 groups, Group A patients have more late-onset (6 in Group A vs 0 in Group B, P = 0.026) and overall tunnel obstructions (10 in Group A vs 0 in Group B, P = 0.001). Concomitant tricuspid procedures significantly reduced intracardiac obstruction (0 in 16 vs 10 in 24, P = 0.003) without development of any tricuspid regurgitation and stenosis. CONCLUSIONS: Using appropriate intracardiac tunnel establishment strategy and techniques, biventricular repair of DORVncVSD is feasible with encouraging outcomes. Concomitant tricuspid procedures can reduce intracardiac tunnel geometry without increase of mortality and morbidity. SN - 1873-734X UR - https://www.unboundmedicine.com/medline/citation/25612745/Biventricular_repair_for_double_outlet_right_ventricle_with_non_committed_ventricular_septal_defect_ L2 - https://academic.oup.com/ejcts/article-lookup/doi/10.1093/ejcts/ezu523 DB - PRIME DP - Unbound Medicine ER -