European Journal of Cardio-Thoracic Surgery, Vol 2, 176-184, Copyright © 1988 by European Association for Cardio-thoracic Surgery
Exclusive double outlet right ventricle with atrioventricular concordance and pulmonary stenosis. Results of reconstructive surgery
J Busquet, F Fontan, A Choussat, G Caianiello and G Fernandez
Hopital Cardiologique du Haut-Leveque, Pessac-Bordeaux, France.
Double outlet right ventricle associated with atrioventricular concordance,
pulmonary stenosis and situs solitus of the atria is a subset of double
outlet right ventricle related through the surgical treatment. From 1974 to
1985, 14 patients, 5 males, 9 females (mean age 8.9 years, range 13
months-22 years) were operated upon. All patients had infundibular stenosis
and normal or large pulmonary arteries. The apex of the heart was to the
right in 2 patients, the right and left ventricles were superior and
inferior in 2 patients and 1 patient had both anomalies. The ventricular
septal defect was subaortic in 11 patients (aorto-mitral discontinuity in
5) and non-committed in 3 patients. Three patients had 2 ventricular septal
defects. The aorta was anterior in 3 patients and to the right of the
pulmonary artery in 11 patients. All patients, through a transventricular
and transatrial approach, had a reconstructive surgery. In 3 patients, an
aortic homograft valved conduit was used. One patient had the ventricular
septal defect enlarged. There was one early death (7.1%) from high residual
right ventricle pressure and no late death. One patient had a transient
atrioventricular block. One patient was reoperated upon for a residual
ventricular septal defect. All survivors had a good clinical result.
Re-evaluation in 8 patients confirmed excellent haemodynamics: the right
ventricle to pulmonary artery pressure gradient decreased from 80 mm Hg
(range 60-95) preoperatively to 24 mm Hg (range 3-32)
postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)
