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Double-outlet right ventricle with non-committed ventricular septal defect
E Belli1, A Serraf, F Lacour-Gayet
1Marie Lannelongue Hospital, Le Plessis-Robinson, France.
Summary
Biventricular repair is a feasible surgical option for double-outlet right ventricle (DORV) with non-committed ventricular septal defects (VSD). This approach yields comparable results to other DORV subsets, though subaortic stenosis is a potential long-term risk.
Area of Science:
- Congenital heart surgery
- Pediatric cardiology
- Cardiac surgery outcomes
Background:
- Double-outlet right ventricle (DORV) with non-committed ventricular septal defect (VSD) presents unique surgical challenges.
- The term 'non-committed' describes VSDs anatomically distant from both great vessels.
- Surgical management of this specific DORV subset requires careful consideration.
Purpose of the Study:
- To report the surgical experience and outcomes of biventricular repair in patients with DORV and non-committed VSD.
- To evaluate the feasibility and effectiveness of this surgical strategy.
Main Methods:
- A retrospective review of 23 patients with DORV and non-committed VSD who underwent biventricular repair between 1987 and 1997.
- Surgical techniques included intraventricular baffle repair and arterial switch operation with VSD to pulmonary artery baffle.
- Concomitant VSD enlargement was performed in 52% of patients.
Main Results:
- Two hospital deaths (9%) occurred.
- Eight patients (35%) required reoperations, primarily for subaortic stenosis.
- All surviving patients were asymptomatic at last follow-up, with only two requiring cardiac medication.
Conclusions:
- Biventricular repair of DORV with non-committed VSD is achievable in most cases.
- Outcomes are comparable to other DORV patient groups.
- The subaortic region remains at risk for stenosis development post-repair.