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Ann Thorac Surg 1979;27:121-129
© 1979 The Society of Thoracic Surgeons

Articles

Surgical Treatment of Double-Outlet Left Ventricle in 2 Patients with D-Position and L-Position of the Aorta

T. Stegmann, M.D.*, H. Oster, M.D., J. Bissenden, M.D., H.C. Kallfelz, M.D., H. Oelert, M.D.

From the Department of Thoracic and Cardiovascular Surgery, Hannover Medical School, Hannover, West Germany

Accepted for publication June 8, 1978.

* Address reprint requests to Dr. Stegmann, Department of Thoracic and Cardiovascular Surgery, Hannover Medical School, 3000 Hannover 61, West Germany

Two cases of double-outlet left ventricle (DOLV) are described, 1 with D-position and 1 with L-position of the aorta. Both patients had situs solitus, atrioventricular concordance with D-relationship of the two ventricles, a ventricular septal defect, and subpulmonary stenosis. The patient with D-position of the aorta was operated on using a technique similar to that for repair of Fallot's tetralogy but including emergency implantation of a bio-prosthesis into the pulmonary artery position on the eighth postoperative day. Surgical correction in the patient with L-position of the aorta required the implantation of a composite valved conduit between the right ventricle and the pulmonary artery.

The various surgical techniques for correction of DOLV are described, and the literature is reviewed. Postoperative right heart failure in both patients is explained by the impaired function of the right ventricle being exposed to gross pulmonary incompetence or by the persistence of elevated right ventricular pressure.




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