Biventricular repair in double outlet right ventricle: surgical results based on the STS-EACTS International Nomenclature classification☆

Abstract

The STS-EACTS International Nomenclature provides more uniform analysis of outcomes with respect to acceptable surgical risk and mortality. Biventricular repair can be safely achieved on selected DORV, including DORV-ncVSD and DORV with AVSD and heterotaxy lesions traditionally indicated for a single ventricle palliative approach.

Implications of incising the ventricular septum in double outlet right ventricle and in the Ross–Konno operation☆

“…A patient, who had an associated multiple VSD repair, required a late heart transplantation. As already reported [3,14], the presence of a Swiss cheese VSD is a contra-indication for biventricular repair and should indicate a Fontan palliation. It is noticeable that the patients requiring a VSD enlargement did not have a significantly higher risk for both total mortality plus late heart transplant ( p = 0.093).…”

“…Stellin et al in 1991 described having to enlarge the VSD in 57% of their hearts with DORV and a non-committed VSD [13]. In our personal experience the incidence of non-committed VSDs needing enlargement was 70% (7/10) with a 10% surgical mortality rate [14]. In order to preserve a two-ventricle system without creating unnecessary LV outflow/subaortic obstruction, an intraventricular tunnel baffle to the pulmonary artery, combined with arterial switch, has been our preferred method of treating non-committed type DORV [4,14].…”

Impact of anatomic characteristics and initial biventricular surgical strategy on outcomes in various forms of double-outlet right ventricle

“…4,5 Previous series reported successful biventricular surgical repair in different anatomic subtypes of DORV. [6][7][8] Thus far, however, 2 points still remain unclear: which surgical strategy implies a higher risk of mortality or reoperation and when to abandon the ambition of biventricular repair. In this study, we sought to determine the risk factors for mortality and reoperation in those with DORV undergoing biventricular repair according to anatomic characteristics and initial surgical strategy.…”

“…Initial surgical strategy did not influence the late outcomes. (J Thorac Cardiovasc Surg 2016;-: [1][2][3][4][5][6][7][8][9] Freedom from reoperation according to surgical strategy.…”

Surgical Treatment of Double Outlet Right Ventricle with Absent Pulmonary Valve and Bronchiarctia

“…The autologous pericardium with three leaflets was used to widen the right ventricle outflow tract to avoid the stenosis and reduce the pulmonary valve regurgitation. [23] Residual shunt should also be avoided. It is quite difficult for patients with bronchiarctia to recover, but most of them can recover uneventfully by strengthening the airway care, taking physical therapy, and preventing and managing infection postoperatively.…”