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Ann Thorac Surg 1997;64:729
© 1997 The Society of Thoracic Surgeons

Discussion

Discussion

The first 20% of the full text of this article appears below.

See also page 721.

DR THOMAS L. SPRAY (Philadelphia, PA): I congratulate Dr Brauner and his associates on an excellent series with quite impressive results in a group of patients that has traditionally represented a very poor surgical outcome.

I have several questions that perhaps are not so much related to the data, which I think speak for themselves, but perhaps to some speculation for future therapy on some of these patients.

First, I noted that in your article, which you kindly provided to me, patients with hypoplastic left heart syndrome were excluded from this study. I wonder with the multiple levels of left heart obstruction what criteria were used to define an adequate left ventricular size and function.

One of the problems with patients with Shone's anomaly is that they tend to present, as in your series, with coarctation. And it is not until after the coarctation is relieved that these patients show their other multiple levels of obstruction. Therefore, I wonder how you define what an adequate left ventricular size and left ventricular function is in a newborn presenting with complex left ventricular outflow tract obstruction.

The second question concerns the average age at repair of the mitral valve, about 2 years, but the two repair failures were in . . . [Full Text of this Article]


Related Article

Multiple Left Heart Obstructions (Shone's Anomaly) With Mitral Valve Involvement: Long-Term Surgical Outcome
Ron A. Brauner, Hillel Laks, Davis C. Drinkwater, Jr, Frank Scholl, and Sharon McCaffery
Ann. Thorac. Surg. 1997 64: 721-729. [Abstract] [Full Text]





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Copyright © 1997 by The Society of Thoracic Surgeons.