The Annals of Thoracic Surgery, Vol 42, 554-559, Copyright © 1986 by The Society of Thoracic Surgeons
Successful repair of double-outlet right ventricle by a modified Fontan operation
T Abe, K Sugiki and S Komatsu
Patients having a double-outlet right ventricle with an unfavorable anatomy
for reparative conduit procedure present a formidable surgical challenge.
Three such patients, aged 10, 13, and 14 years, with double- outlet right
ventricle associated with atrioventricular discordance in 2 and
atrioventricular concordance in 1, levotransposition of the great vessels
and dextrocardia. A large-diameter direct anastomosis of the right atrium
to the pulmonary artery was performed after the closure of the
atrioventricular and pulmonary valves. All patients were operated on
successfully with good clinical and hemodynamic results. Postoperatively,
all 3 were acyanotic and had an improved physical activity compared with
their preoperative status. Mean cardiac index at rest was 3.23 L/min/m2 and
was increased to 5.04 L/min/m2 during exercise. These results indicate that
this procedure can be of value for patients with double-outlet right
ventricle in whom reparative surgery is technically difficult or
infeasible.
