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Ann Thorac Surg 2002;73:699
© 2002 The Society of Thoracic Surgeons

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Correspondence

Double-inlet left ventricle: successfully staged ventricular septation with 12.5 years follow-up

^a Center for Congenital Heart Disease Amsterdam-Leiden, s/c PO Box 9600, 2300 RC Leiden, The Netherlands

e-mail: j.ottenkamp{at}lumc.nl

To the Editor

It is with great interest that we read the case report of Naito and colleagues [1]. They described ventricular septation for double-inlet left ventricle in early infancy with a follow-up of 9 years. They state, however, that no successful case of primary septation had been reported thus far, and overlooked a case report of a baby with identical cardiac anatomy who underwent staged septation [2].

Our patient has been operated on by Prof. Quaegebeur with a staged procedure in which he first inserted a perforated Dacron patch inside the large left ventricle with the double inlet and banded the pulmonary artery. The septation was completed at age 3 years with closure of the perforation in the patch between both newly created ventricles, debanding of the pulmonary artery, and enlargement of the ventricular defect between the newly formed left ventricle and the originally hypoplastic right ventricle giving rise to the aorta.

Immediately after the completion of septation the right ventricular systolic pressure was 25 mm Hg with a systolic left ventricular pressure of 80 mm Hg. The boy has been followed as an outpatient for more than 12.5 years after completion of the septation, and is doing well. His heart size has decreased to normal, and he has a stable sinus rhythm. There is, however, slight to moderate regurgitation of the right atrioventricular valve connected to the newly formed right ventricle. At the moment he is almost 16 years of age, attending 3rd class of secondary school, and playing soccer, without medication and without limitations. His weight is 40 kg and his height 161 cm.

We sincerely agree with Naito and colleagues that in these relatively infrequent forms of univentricular atrioventricular connection, ventricular septation should be seriously considered to prevent the well-known disadvantages of a Fontan circulation.

References

1. Naito Y., Fujiwara K., Komai H., Uemura S. Midterm results after ventricular septation for double-inlet left ventricle in early infancy. Ann Thorac Surg 2001;71:1344-1346.[Abstract/Free Full Text]
2. Bogers A.J.J.C., Quaegebeur J.M., Ottenkamp J., Hess J., Bos E. A modification of staged septation for univentricular atrioventricular connection. J Thorac Cardiovasc Surg 1992;104:204-205.[Abstract]

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This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Mark G. Hazekamp Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ottenkamp, J. Articles by Hazekamp, M. G. Search for Related Content PubMed Articles by Ottenkamp, J. Articles by Hazekamp, M. G. Related Collections Congenital - cyanotic History Related Article