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

Villemain, Olivier; Belli, Emrè; Ladouceur, Magalie; Houyel, Lucile; Jalal, Zakaria; Lambert, Virginie; Ly, Mohamed; Vouhé, Pascal; Bonnet, Damien

doi:10.1016/j.jtcvs.2016.05.019

Cited by 27 publications

(15 citation statements)

References 21 publications

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“…It can exist as a single malformation or as part of other complex cardiac malformations, such as tetralogy of fallot, complete atrioventricular malformation, transposition of the great arteries, tricuspid atresia, and double outlet of the right ventricle. The location, size and shape of aortic valve orifice and VSD are the key to preoperative preparation (Villemain et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Numerical Simulation of the Influence of Geometric Configurations on Pressure Difference in the Intraventricular Tunnel

et al. 2020

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Simulation of Pressure Difference in the Intraventricular Tunnel Conclusion: R TT in the IVT is the main factor affecting the pressure difference. A small R TT will lead to a large pressure difference in the IVT. When R TT increases to 6 mm, the pressure difference in the IVT remains nearly unchanged. When performing the right ventricular double outlet correction; the turning radius of the IVT should be about 6 mm to ensure relatively small pressure difference.

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Section: Introductionmentioning

confidence: 99%

Numerical Simulation of the Influence of Geometric Configurations on Pressure Difference in the Intraventricular Tunnel

et al. 2020

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“…Correction of VSD type DORV is not difficult when an intracardiac channel procedure is performed, with generally good results. [ 9 ] In infants <1 year old, however, we found that residual shunts could be inadvertently created in the intracardiac channel, especially for DORV with remote VSD. This could be owing to more difficult exposure of the surgical field, myocardial fragility, and difficulty in suturing.…”

Section: Discussionmentioning

confidence: 90%

“…Four types of DORV (tetralogy of Fallot [TOF] type, transposition of the great arteries [TGAs] type, ventricular septal defect [VSD] type, and remote VSD type) have been classified, and different procedures described for the different types of DORV, with varied rates of success and frequently high mortality. [ 3 4 5 6 7 8 9 ]…”

Section: Introductionmentioning

confidence: 99%

Surgical Treatment of Double Outlet Right Ventricle Complicated by Pulmonary Hypertension

et al. 2017

Chinese Medical Journal

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Background:Double outlet right ventricle (DORV) is a group of complex congenital heart abnormalities. Preoperative pulmonary hypertension (PH) is considered an important risk factor for early death during the surgical treatment of DORV. The aim of this study was to report our experience on surgical treatment of DORV complicated by PH.Methods:From June 2004 to November 2016, 61 patients (36 males and 25 females) aged 2 weeks to 26 years (median: 0.67 years and interquartile range: 0.42–1.67 years) with DORV (two great arteries overriding at least 50%) complicated by PH underwent surgical treatment in our center. All patients were categorized according to surgical age and lesion type, respectively. Pulmonary artery systolic pressure (PASP), pulmonary artery diastolic pressure (PADP), and mean pulmonary artery pressure (mPAP) were measured directly before cardiopulmonary bypass (CPB) was established and after CPB was removed. An intracardiac channel procedure was performed in 37 patients, arterial switch procedure in 19 patients, Rastelli procedure in three patient, Senning procedure in one patients, and Mustard procedure in one patient. The Student's t-test and Chi-squared test were performed to evaluate clinical outcomes of the surgical timing and operation choice.Results:Fifty-five patients had uneventful recovery. PASP fell from 55.3 ± 11.2 mmHg to 34.7 ± 11.6 mmHg (t = 14.05, P < 0.001), PADP fell from 29.7 ± 12.5 mmHg to 18.6 ± 7.9 mmHg (t = 7.39, P < 0.001), and mPAP fell from 40.3 ± 10.6 mmHg to 25.7 ± 8.3 mmHg (t = 11.85, P < 0.001). Six (9.8%) patients died owing to complications including low cardiac output syndrome in two patients, respiratory failure in two, pulmonary hemorrhage in one, and sudden death in one patient. Pulmonary artery pressure (PAP) dropped significantly in infant and child patients. Mortality of both infants (13.9%) and adults (33.3%) was high.Conclusions:PAP of patients with DORV complicated by PH can be expected to fall significantly after surgery. An arterial switch procedure can achieve excellent results in patients with transposition of the great arteries type. Higher incidence of complications may occur in patients with ventricular septal defect (VSD) type before 1 year of age. For those with remote VSD type, VSD enlargement and right ventricle outflow tract reconstruction are usually required with acceptable results. The degree of aortic overriding does not influence surgical outcome.

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“…1 Em presença de CIV não relacionada como no caso em exposição, a técnica idealizada por Barbero-Marcial 3 direciona o VE para a aorta com tunelização com remendos desde a CIV até a valva aórtica, e com alívio da estenose pulmonar aplicada com relativo sucesso em face de sobrevida de 86,5% após 10 anos. 4,5 Outra técnica, como o direcionamento pela CIV à artéria pulmonar e troca arterial subsequente, também se torna viável.…”

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Dupla Via de Saída de Ventrículo Direito com Comunicação Interventricular não Relacionada e Estenose Pulmonar, em Evolução Natural, em Mulher com 36 Anos

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2021

Arquivos Brasileiros De Cardiologia

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

Cited by 27 publications

References 21 publications

Numerical Simulation of the Influence of Geometric Configurations on Pressure Difference in the Intraventricular Tunnel

Numerical Simulation of the Influence of Geometric Configurations on Pressure Difference in the Intraventricular Tunnel

Surgical Treatment of Double Outlet Right Ventricle Complicated by Pulmonary Hypertension

Dupla Via de Saída de Ventrículo Direito com Comunicação Interventricular não Relacionada e Estenose Pulmonar, em Evolução Natural, em Mulher com 36 Anos

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