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ventricular septation for double inlet left ventricle

Jeffrey Phillip Jacobs, Bohdan Maruszewski
BACKGROUND: "The term "functionally univentricular heart" describes a spectrum of congenital cardiovascular malformations in which the ventricular mass may not readily lend itself to partitioning that commits one ventricular pump to the systemic circulation and another to the pulmonary circulation." The purpose of this article is to review patterns of practice and outcomes in the Congenital Heart Surgery Databases (CHSDBs) of the European Association for Cardio-Thoracic Surgery (EACTS) and the Society of Thoracic Surgeons (STS) in patients with functionally univentricular hearts undergoing the Fontan operation...
October 2013: World Journal for Pediatric & Congenital Heart Surgery
Hiromi Kurosawa, Tatsuta Arai, Yasuharu Imai, Goki Matsumura
Ventricular septation is a biventricular repair for certain types of functionally univentricular hearts. Double inlet left ventricle (DILV) is one type of functionally univentricular heart which in certain instances is amenable to ventricular septation. Thirty-four patients underwent ventricular septation for DILV from 1971 to 2000. Hospital death occurred in seven and late death in two. Mean follow-up period was 15 years. Actuarial survival rate was 73.3% (24 patients) at 15 years, 73.3% (15 patients) at 20 years, 73...
July 1, 2012: World Journal for Pediatric & Congenital Heart Surgery
Shuichi Shiraishi, T Yagihara, K Kagisaki, I Hagino
The purpose of this study is to analyze the operative maneuver and long term outcome of the arterial switch operation (ASO) for congenitally corrected transposition of the great arteries (c-TGA) or double inlet left ventricle (DILV). Since October 1977, 221 patients had undergone ASO in National Cardiovascular Center, Japan. Of these, 8 patients underwent ASO as a part of double switch operation (DSO) for c-TGA, and 1 patient underwent ASO and ventricular septation for the DILV with a rudimentary right ventricle simultaneously...
April 2008: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Hideo Ohuchi, Kenichi Watanabe, Kanako Kishiki, Masaki Nii, Yuko Wakisaka, Toshikatsu Yagihara, Shigeyuki Echigo
Ventricular septation (VS) and the Fontan procedure are alternatives for definitive repair in patients with double-inlet left ventricle; although VS is theoretically preferable, the current preference in practice is the Fontan procedure. However, the long-term outcomes of both procedures remain unclear. To address this issue, cardiopulmonary responses during exercise were measured in patients with double-inlet left ventricle, and the impact of the type of procedure performed, Fontan or VS, on long-term exercise capacity and late postoperative clinical profiles was assessed...
June 15, 2007: American Journal of Cardiology
Renee E Margossian, David Solowiejczyk, Francois Bourlon, Howard Apfel, Welton M Gersony, Allan J Hordof, Jan Quaegebeur
BACKGROUND: Septation of a single ventricle into 2 functioning ventricles can provide an alternative to the Fontan operation. However, early experiences with septation reported unacceptable morbidity and mortality. The present study selected only those patients with large volume-overloaded hearts, 2 well-functioning atrioventricular valves, and an absence of severe outlet obstruction. Early and intermediate outcomes are evaluated. METHODS AND RESULTS: Between June 1990 and March 1999, 11 patients underwent septation in 1 or 2 stages...
September 2002: Journal of Thoracic and Cardiovascular Surgery
Y Naito, K Fujiwara, H Komai, S Uemura
We performed ventricular septation for a 40-day-old boy with double-inlet left ventricle and discordant ventriculoarterial connection but without pulmonary stenosis. Postoperative cardiac function is satisfactory, with no evidence of pulmonary hypertension or subaortic stenosis. Nine years after the operation, the patient has an active life, is free from symptoms, and requires no medication. He may be the first patient to survive ventricular septation for double-inlet left ventricle in early infancy.
April 2001: Annals of Thoracic Surgery
M Nagashima, Y Imai, Y Takanashi, S Hoshino, K Seo, M Terada, M Aoki
BACKGROUND: Ventricular septation is an option for surgical correlation of double-inlet or common-inlet left ventricle. However, the surgical risk factors of ventricular septation remain unknown. METHODS: Twenty-three patients with double-inlet or common-inlet left ventricle underwent ventricular septation. Preoperative data were compared between the survivors (n = 18) and the nonsurvivors (n = 5) to assess surgical risk factors. RESULTS: There were two early deaths (9...
September 1997: Annals of Thoracic Surgery
G M Hutchins, M A Meredith, G W Moore
To examine the hypothesis that malpositions of cardiac ventricles could be explained by altered development of the interventricular septum, we studied hearts from the Johns Hopkins Hospital autopsy files with double inlet left ventricle (16 cases) or corrected transposition (nine cases). In double inlet left ventricle (16 cases) or corrected transposition (nine cases). In double inlet ventricle both atrioventricular valves connect normally developed and positioned right and left atria to a posterior morphologic left ventricle...
March 1981: Human Pathology
G Stefanelli, J W Kirklin, D C Naftel, E H Blackstone, A D Pacifico, J K Kirklin, B Soto, L M Bargeron
One hundred sixteen patients with "single ventricle" underwent 147 operations between 1967 and July 1982, with an actuarial survival rate (hospital deaths are included in all actuarials) at 10 years of 66%. One hospital death (2%) occurred after 45 primary "classic" shunting operations, and the 10-year actuarial survival was 85%. There were no hospital deaths after atrial septectomy or pulmonary artery banding, and the 10-year actuarial survival rate after these as initial procedures was 76% and 74%, respectively...
October 1, 1984: American Journal of Cardiology
D A Girod, R C Lima, R H Anderson, S Y Ho, M L Rigby, J M Quaegebeur
We analyzed, using a sequential segmental approach, 32 cases of double-inlet ventricle to assess the feasibility of surgical "correction" by either ventricular septation or a modified Fontan procedure. Twenty-two hearts had two atrioventricular valves, connected to a left ventricle in 19, a right ventricle in two, and a solitary indeterminate ventricle in one. Septation was possible in only 13. In contrast, the Fontan procedure seemed feasible in 20. The remaining 10 specimens had double inlet via a common valve to the left ventricle in two, the right ventricle in six, and an indeterminate ventricle in two...
October 1984: Journal of Thoracic and Cardiovascular Surgery
R A Jonas, A R Castaneda, P Lang
Intracardiac obstruction to the systemic circulation can develop in patients with many forms of congenital heart disease. When transposition of the great arteries accompanies tricuspid atresia, narrowing of the ventricular septal defect (VSD) leads to subaortic stenosis. In a similar fashion, a restrictive bulboventricular foramen compromises systemic arterial outflow in patients who have single left ventricle with subaortic outflow chamber. The same effect can be seen in VSD closure in mitral atresia with normally related great vessels...
April 1985: Annals of Thoracic Surgery
R McKay, R M Bini, J P Wright
Complete septation of a double inlet left ventricle with left anterior subaortic outlet chamber was carried out successfully as a staged procedure during the first two years of life in a patient with severe pulmonary hypertension and an abnormal left atrioventricular valve. In contrast with isolated pulmonary artery banding, which rarely has led to a satisfactory septation or modified Fontan operation, this technique achieved good initial palliation and uncomplicated intracardiac repair. It should be considered for infants with univentricular atrioventricular connection, two atrioventricular valves, and excessive pulmonary blood flow...
December 1986: British Heart Journal
G Stellin, A Mazzucco, U Bortolotti, G Faggian, U Livi, A Angelini, V Gallucci
We report a patient in whom orthotopic heart transplantation was performed after late failure of ventricular septation for double-inlet left ventricle. This case shows that orthotopic heart transplantation represents a valid therapeutic alternative in children with previous correction of complex congenital heart defects not amenable to further intracardiac repair.
October 1989: Annals of Thoracic Surgery
G Isabella, L Daliento, R Chioin, O Milanesi, R Razzolini, S Dalla Volta
Using quantitative cineangiography we studied left ventricular size and function in 15 patients (aged 1 day to 15 years) with double inlet left ventricle. Our purpose was to assess how ventricular volume and performance change with age and palliative surgery in patients with and without restriction to pulmonary flow. Ventricular volumes were calculated using Simpson's rule method; end-diastolic volume was also stated as a percentage of predicted total (combined right and left) ventricular volume. Ejection fraction and systolic pressure to end-systolic volume ratio were calculated as indexes of ventricular function...
October 1988: International Journal of Cardiology
M Nakazawa, H Aotsuka, Y Imai, H Kurosawa, S Fukuchi, G Satomi, A Takao
Septation is one of the surgical choices for double-inlet left ventricle, yet postoperative hemodynamics have not been well defined. We studied ventricular volume characteristics in 10 patients with double-inlet left ventricle before and after septation. Preoperative end-diastolic volume (EDV) of the ventricle was 291 +/- 111% (+/- SD) of normal and ejection fraction (EF) was 0.59 +/- 0.07. Postoperatively, EDV of the right-sided ventricle (RV) was 82 +/- 24%, and EDV of the left-sided ventricle (LV) was 153 +/- 41%...
May 1990: Circulation
H Ohuchi, T Yagihara, H Kishimoto, F Isobe, F Yamamoto, Y Kawashima
A 5-year-old boy with double inlet left ventricle and ventriculoarterial discordance (SDD type) underwent ventricular septation with arterial switch procedure. Previously he had received pulmonary arterial banding at 3 months-old. Preoperative cardiac catheterization revealed Qp/Qs 1.26, Pp/Ps 0.19 and LVEDV was 315% of normal (as left ventricle). Arterial switch with Lecompte modification was performed in order to separate ventricle with straight patch could be done. Post operative course was uneventful and patient was extubated 4 post operative day...
December 1991: [Zasshi] [Journal]
Y Koh, Y Imai, H Kurosawa, K Soejima, S Fukuchi, K Sawatari, M Kawada, K Matsuo, T Shinoka, M Yamagishi
Thirteen patients with double-inlet left ventricle who had undergone pulmonary artery banding (PAB) were reviewed. At the time of PAB, the age ranged from 2 months to 3 years. Pulmonary-systemic arterial pressure ratio and pulmonary arterial mean pressure were reduced from 0.95 +/- 0.12 to 0.4 +/- 0.18, and from 57.3 +/- 11.6 mmHg to 29.9 +/- 12.7 mmHg after PAB. Pulmonary resistance showed no statistically significant change after PAB. (from 7.6 +/- 5.2 unit to 4.8 +/- 3.9 unit) Ventricular end-diastolic volume decreased from 379...
February 1990: [Zasshi] [Journal]
A J Bogers, J M Quaegebeur, J Ottenkamp, J Hess, E Bos
A case is reported in which is described a modification of staged septation for univentricular atrioventricular connection with double-inlet left ventricle and left-sided rudimentary outlet chamber beneath the aorta. This modification diminishes the risk of atrioventricular conduction disturbances by gluing the perforated septation patch on the myocardium in the area overlying the central conduction system. Fixation of the patch was facilitated by exact fitting of the patch in this area, by ample contact of the patch and the myocardium in this area, and by immobilization of the patch because of equal pressures on both sides because of the perforation of the patch...
July 1992: Journal of Thoracic and Cardiovascular Surgery
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