Long-term results of ventricular septation for double-inlet left ventricle†

Author:

Shimada Masatoshi1,Hoashi Takaya1,Nakata Tomohiro1,Kurosaki Kenichi2,Kanzaki Suzu3,Shiraishi Isao2,Ichikawa Hajime1

Affiliation:

1. Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan

2. Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan

3. Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan

Abstract

AbstractOBJECTIVESTo review the long-term surgical outcomes of ventricular septation for double-inlet left ventricle and reconsider the possibility of ventricular septation as an option of surgical treatments.METHODSBetween 1978 and 1994, 22 patients with double-inlet left ventricle underwent ventricular septation. The mean age at operation was 5.3 years (range 0–22 years). Follow-up was carried out in 20 of 22 patients (91%) and the mean follow-up period was 14.7 years (range 0–39 years).RESULTSActuarial survival and reoperation-free survival rates at 30 years were 49% and 21%, respectively. To date, 8 patients have been followed up. Among them, atrioventricular valve replacement and permanent pacemaker were required in 4 and 7 patients, respectively. Late cardiac catheter examination at 25.5 years after surgery showed that the median cardiac index was 2.6 l/min/m2 (range 2.1–3.4 l/min/m2), left ventricular end-diastolic pressure was 7 mmHg (range 4–11 mmHg), left ventricular ejection fraction was 50% (range 27–63%), right ventricular ejection fraction was 53% (range 31–66%) and central venous pressure was 6 mmHg (range 4–11 mmHg). At the latest follow-up, the New York Heart Association Functional Classification was I for 5 patients, II for 2 patients and III for 1 patient. The median peak oxygen uptake was 52.9% (range 44.1–93.5%).CONCLUSIONSSome patients with double-inlet left ventricle were able to maintain low central venous pressure and a sufficient cardiac index long after ventricular septation. Although the single ventricle strategy remains a first-line treatment, ventricular septation can be a surgical treatment option.

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine,Pulmonary and Respiratory Medicine,General Medicine,Surgery

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1. Ventricular Septation of the Double-Inlet Ventricle: Over Three Decades of Follow-Up;Pediatric Cardiology;2024-06-15

2. Imaging of Double Inlet Left Ventricle;Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual;2024

3. Staged Ventricular Septation of the Double-Inlet Ventricle: How-I-Do-It;Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual;2024

4. Double Inlet Ventricle;Pediatric Cardiology;2024

5. Ventricular Septation of the Double-Inlet Ventricle: Over Three Decades of Follow-Up;2023-12-08

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