HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): David B. Ross Robert H. Anderson Christopher Lincoln Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Jahangiri, M. Articles by Lincoln, C. Search for Related Content PubMed PubMed Citation Articles by Jahangiri, M. Articles by Lincoln, C. Related Collections Congenital - cyanotic

Ann Thorac Surg 2001;71:907-910
© 2001 The Society of Thoracic Surgeons

---

Original article: cardiovascular

Long-term results of relief of subaortic stenosis in univentricular atrioventricular connection with discordant ventriculoarterial connections

^a Department of Cardiology and Cardiac Surgery, Royal Brompton Hospital, London, England, United Kingdom
^b Department of Cardiac Surgery, IWK-Grace Health Center, Halifax, Nova Scotia, Canada

Accepted for publication October 18, 2000.

Address reprint requests to Dr Jahangiri, Department of Cardiac Surgery, Great Ormond Street Hospital for Children, Great Ormond St, London WC1N 3JH, England

Background. We set out to examine the long-term results of relief of subaortic stenosis by enlargement of ventricular septal defect in patients with univentricular atrioventricular connection to a dominant left ventricle and discordant ventriculoarterial connections.

Methods. Twenty-four patients underwent enlargement of ventricular septal defect between 1985 and 1998 at a median age of 3.2 years (range, 3 weeks to 14 years). Ten patients were younger than 1 year of age. Eighteen had undergone previous banding of the pulmonary trunk, 9 of whom also required repair of coarctation of the aorta. The median subaortic gradient before enlargement was 46 mm Hg. Twenty-three patients had a patch to enlarge the rudimentary right ventricle.

Results. Five patients (21%) died in the early postoperative period. The overall survival at 1 and 3 years was 73%, and at 5 and 10 years was 68% and 60%, respectively. Complete heart block requiring insertion of a pacemaker occurred in 2 patients (8%). A Fontan operation was performed in 10 patients, 5 underwent a bidirectional Glenn procedure, and 2 required cardiac transplantation. Follow-up was complete in all survivors at a median time of 6.7 years (range, 8 months to 13 years). From the earlier part of the series, 3 patients experienced aortic insufficiency and 2 had recurrent obstruction. Factors adversely affecting survival were age younger than 1 year at operation and presence of obstruction within the aortic arch.

Conclusions. Our experience shows that, in patients with univentricular atrioventricular connection to a dominant left ventricle and subaortic stenosis, enlargement of the ventricular septal defect provides satisfactory relief of obstruction except in those younger than 1 year of age, and those who have associated obstruction in the aortic arch.

This article has been cited by other articles:

				A. A. Lotto, R. Hosein, T. J. Jones, D. J. Barron, and W. J. Brawn Outcome of the Norwood procedure in the setting of transposition of the great arteries and functional single left ventricle Eur. J. Cardiothorac. Surg., January 1, 2009; 35(1): 149 - 155. [Abstract] [Full Text] [PDF]