Kunio Kusajima1, Takaya Hoashi2, Koji Kagisaki1, Hideo Ohuchi3, Isao Shiraishi3, Hajime Ichikawa1. 1. Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, 565-8565, Osaka, Japan. 2. Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, 565-8565, Osaka, Japan. thoashi@surg1.med.osaka-u.ac.jp. 3. Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan.
Abstract
OBJECTIVE: Surgical experiences of the reoperative double ventricular outflow tract reconstruction long after the successful repair of conotruncal anomalies were reviewed. METHODS: Ten adult patients with conotruncal anomalies (6 females, 22.9 ± 5.5 years old) underwent the reoperative double ventricular outflow tract reconstruction. Primary diagnosis was pulmonary atresia with ventricular septal defect in 6 patients, truncus arteriosus in 3, and double-outlet right ventricle in 1. The indication for the left ventricular outflow tract reconstruction was the left ventricular dilatation and dysfunction derived from moderate or greater systemic semilunar valve insufficiency. The indication for the right ventricular outflow tract reconstruction was severe pulmonary insufficiency in all patients, and concomitant right ventricular outflow tract obstruction in 7. RESULTS: The systemic semilunar valve replacement was performed in all patients. The right ventricular outflow tract patching was performed in 4 patients, and the revision of extra-cardiac conduit in 6. Within a mean follow-up of 9.0 ± 7.0 years, there was no mortality. The left ventricular end-diastolic volume index improved from 147 ± 37 to 108 ± 19 ml/m(2) (p = 0.005), and the peak pressure gradient across right ventricular outflow tract improved from 43 ± 17 mmHg to 9 ± 2 at 1 year after (p = 0.02). The plasma brain natriuretic peptide level improved from 83 ± 57 to 34 ± 32 pg/ml (p = 0.03). CONCLUSIONS: Reoperative double ventricular outflow tract reconstruction long after the repair of conotruncal anomalies was safely performed, and provided the ventricular reverse remodeling and improvement of serum BNP level.
OBJECTIVE: Surgical experiences of the reoperative double ventricular outflow tract reconstruction long after the successful repair of conotruncal anomalies were reviewed. METHODS: Ten adult patients with conotruncal anomalies (6 females, 22.9 ± 5.5 years old) underwent the reoperative double ventricular outflow tract reconstruction. Primary diagnosis was pulmonary atresia with ventricular septal defect in 6 patients, truncus arteriosus in 3, and double-outlet right ventricle in 1. The indication for the left ventricular outflow tract reconstruction was the left ventricular dilatation and dysfunction derived from moderate or greater systemic semilunar valve insufficiency. The indication for the right ventricular outflow tract reconstruction was severe pulmonary insufficiency in all patients, and concomitant right ventricular outflow tract obstruction in 7. RESULTS: The systemic semilunar valve replacement was performed in all patients. The right ventricular outflow tract patching was performed in 4 patients, and the revision of extra-cardiac conduit in 6. Within a mean follow-up of 9.0 ± 7.0 years, there was no mortality. The left ventricular end-diastolic volume index improved from 147 ± 37 to 108 ± 19 ml/m(2) (p = 0.005), and the peak pressure gradient across right ventricular outflow tract improved from 43 ± 17 mmHg to 9 ± 2 at 1 year after (p = 0.02). The plasma brain natriuretic peptide level improved from 83 ± 57 to 34 ± 32 pg/ml (p = 0.03). CONCLUSIONS: Reoperative double ventricular outflow tract reconstruction long after the repair of conotruncal anomalies was safely performed, and provided the ventricular reverse remodeling and improvement of serum BNP level.
Authors: Katrien François; Mahmoud Zaqout; Thierry Bové; Kristof Vandekerckhove; Katya De Groote; Joseph Panzer; Hans De Wilde; Daniel De Wolf Journal: Eur J Cardiothorac Surg Date: 2010-02-04 Impact factor: 4.191
Authors: François-Pierre Mongeon; Michelle Z Gurvitz; Craig S Broberg; Jamil Aboulhosn; Alexander R Opotowsky; Joseph D Kay; Anne Marie Valente; Michael G Earing; George K Lui; Susan M Fernandes; Deborah R Gersony; Stephen C Cook; Jennifer Grando Ting; Michelle J Nickolaus; Michael J Landzberg; Paul Khairy Journal: Circulation Date: 2012-12-06 Impact factor: 29.690
Authors: Aditya K Kaza; Hong-Gook Lim; Daniel J Dibardino; Victor Bautista-Hernandez; Joshua Robinson; Catherine Allan; Peter Laussen; Francis Fynn-Thompson; Emile Bacha; Pedro J del Nido; John E Mayer; Frank A Pigula Journal: J Thorac Cardiovasc Surg Date: 2009-07-26 Impact factor: 5.209
Authors: Joseph A Dearani; Harold M Burkhart; John M Stulak; Thoralf M Sundt; Hartzell V Schaff Journal: Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu Date: 2009
Authors: Kimberly A Holst; Joseph A Dearani; Harold M Burkhart; Heidi M Connolly; Carole A Warnes; Zhuo Li; Hartzell V Schaff Journal: Ann Thorac Surg Date: 2013-02-22 Impact factor: 4.330