1. Long-term results of ventricular septation for double-inlet left ventricle†.
- Author
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Shimada M, Hoashi T, Nakata T, Kurosaki K, Kanzaki S, Shiraishi I, and Ichikawa H
- Subjects
- Adolescent, Adult, Child, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Male, Retrospective Studies, Treatment Outcome, Univentricular Heart surgery, Ventricular Function, Left physiology, Young Adult, Cardiac Surgical Procedures adverse effects, Cardiac Surgical Procedures methods, Cardiac Surgical Procedures mortality, Heart Ventricles surgery, Ventricular Septum surgery
- Abstract
Objectives: To review the long-term surgical outcomes of ventricular septation for double-inlet left ventricle and reconsider the possibility of ventricular septation as an option of surgical treatments., Methods: Between 1978 and 1994, 22 patients with double-inlet left ventricle underwent ventricular septation. The mean age at operation was 5.3 years (range 0-22 years). Follow-up was carried out in 20 of 22 patients (91%) and the mean follow-up period was 14.7 years (range 0-39 years)., Results: Actuarial survival and reoperation-free survival rates at 30 years were 49% and 21%, respectively. To date, 8 patients have been followed up. Among them, atrioventricular valve replacement and permanent pacemaker were required in 4 and 7 patients, respectively. Late cardiac catheter examination at 25.5 years after surgery showed that the median cardiac index was 2.6 l/min/m2 (range 2.1-3.4 l/min/m2), left ventricular end-diastolic pressure was 7 mmHg (range 4-11 mmHg), left ventricular ejection fraction was 50% (range 27-63%), right ventricular ejection fraction was 53% (range 31-66%) and central venous pressure was 6 mmHg (range 4-11 mmHg). At the latest follow-up, the New York Heart Association Functional Classification was I for 5 patients, II for 2 patients and III for 1 patient. The median peak oxygen uptake was 52.9% (range 44.1-93.5%)., Conclusions: Some patients with double-inlet left ventricle were able to maintain low central venous pressure and a sufficient cardiac index long after ventricular septation. Although the single ventricle strategy remains a first-line treatment, ventricular septation can be a surgical treatment option., (© The Author(s) 2019. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
- Published
- 2019
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