Challenging a dogma: left ventriculotomy can be used safely in children

Area of Science:

• Pediatric Cardiac Surgery
• Cardiovascular Surgery
• Congenital Heart Disease Surgery

Background:

• Left ventriculotomy is a surgical approach to the left ventricle.
• Its application in pediatric patients requires careful consideration due to potential functional impacts.
• Experience with this procedure in young children is limited.

Purpose of the Study:

• To review the unit's experience with left ventriculotomies in pediatric patients.
• To evaluate the safety and efficacy of left ventriculotomy in children.
• To assess the impact of left ventriculotomy on left ventricular function in pediatric cases.

Main Methods:

• Retrospective review of pediatric patients undergoing left ventriculotomy between 2000 and 2022.
• Data collection included patient demographics, indications for surgery, and pre- and post-operative cardiac function parameters.
• Analysis focused on early and late outcomes, including mortality, arrhythmias, and ventricular function.

Main Results:

• Eight pediatric patients underwent left ventriculotomy, with ages ranging from 5 months to 17 years.
• Indications included cardiac mass excision (7 patients) and pseudoaneurysm repair (1 patient).
• No early or late mortality was observed. Left ventricular function (ejection fraction, fractional shortening) remained comparable post-operatively, with no detected arrhythmias.

Conclusions:

• Apical left ventriculotomy is a safe surgical approach in pediatric patients, including infants.
• The procedure does not compromise left ventricular function.
• Left ventriculotomy can be safely utilized for surgical access to the left ventricle in selected pediatric cases.