دورية أكاديمية
Biventricular repair of atrioventricular septal defect with common atrioventricular valve and double-outlet right ventricle.
| العنوان: | Biventricular repair of atrioventricular septal defect with common atrioventricular valve and double-outlet right ventricle. |
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| المؤلفون: | Devaney EJ; Department of Surgery, Division of Cardiac Surgery, University of Michigan School of Medicine, Ann Arbor, Michigan 48109, USA. edevaney@umich.edu, Lee T, Gelehrter S, Hirsch JC, Ohye RG, Anderson RH, Bove EL |
| المصدر: | The Annals of thoracic surgery [Ann Thorac Surg] 2010 Feb; Vol. 89 (2), pp. 537-42; discussion 542-3. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: Netherlands NLM ID: 15030100R Publication Model: Print Cited Medium: Internet ISSN: 1552-6259 (Electronic) Linking ISSN: 00034975 NLM ISO Abbreviation: Ann Thorac Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Amsterdam : Elsevier Original Publication: Boston. |
| مواضيع طبية MeSH: | Double Outlet Right Ventricle/*surgery , Heart Septal Defects, Atrial/*surgery , Heart Septal Defects, Ventricular/*surgery , Mitral Valve/*abnormalities , Tricuspid Valve/*abnormalities, Blood Vessel Prosthesis Implantation ; Cardiopulmonary Bypass ; Child, Preschool ; Comorbidity ; Double Outlet Right Ventricle/mortality ; Female ; Heart Atria/surgery ; Heart Septal Defects, Atrial/mortality ; Heart Septal Defects, Ventricular/mortality ; Heart Septum/surgery ; Heart Ventricles/surgery ; Hospital Mortality ; Humans ; Infant ; Male ; Postoperative Complications/etiology ; Postoperative Complications/mortality ; Pulmonary Veins/abnormalities ; Retrospective Studies ; Risk Factors ; Situs Inversus/mortality ; Situs Inversus/surgery ; Survival Analysis ; Suture Techniques |
| مستخلص: | Background: The combination of an atrioventricular septal defect with a common atrioventricular junction guarded by a common valve, and double-outlet right ventricle, is a rare lesion that presents a challenge for surgical repair. This report describes our surgical approach and results in 16 patients undergoing biventricular repair for such a combination of lesions. Methods: A retrospective analysis was performed for all patients undergoing biventricular repair of atrioventricular septal defect with common atrioventricular valve and double-outlet right ventricle between 1991 and 2008. Patients with tetralogy of Fallot and common atrioventricular valve were excluded from analysis. Early and actuarial outcomes were evaluated using the chi(2) test for categorical variables and Wilcoxon rank sum for ordinal variables. Results: The median age at operation was 16 months. Heterotaxy syndrome was present in 12 of the 16 patients (9 right isomerism and 3 left isomerism), and 6 had concurrent totally anomalous pulmonary venous connections. Primary repair was achieved in 6 patients, and 10 underwent one or more prior operations (most frequently a shunt, banding of the pulmonary trunk, or repair of the anomalous pulmonary venous connections). Enlargement of the ventricular septal defect by resection of the muscular outlet septum was required in 11 patients, in whom the ventricular septal defect emptied entirely or primarily to the inlet of the right ventricle. A conduit was placed from the right ventricle to the pulmonary arteries in 13. There was 1 death before discharge from hospital, 1 late death, and 2 episodes of heart block. Among survivors, follow-up was complete with a median follow-up of 66 months. No patient had late obstruction of the left ventricular outflow tract. The presence of heterotaxy with totally anomalous pulmonary venous connections was associated with combined mortality and significant morbidity (p = 0.008). Conclusions: Although technically challenging, the surgical repair can be accomplished with acceptable early results. Heterotaxy syndrome, with concurrent anomalous connections of the pulmonary veins, represented the strongest identified risk factor for death or significant complication. (2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.) |
| تواريخ الأحداث: | Date Created: 20100128 Date Completed: 20100217 Latest Revision: 20100127 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1016/j.athoracsur.2009.10.049 |
| PMID: | 20103338 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 1552-6259 |
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| DOI: | 10.1016/j.athoracsur.2009.10.049 |