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Related Experiment Videos

Double-inlet ventricle: morphologic analysis and surgical implications in 32 cases.

D A Girod, R C Lima, R H Anderson

    The Journal of Thoracic and Cardiovascular Surgery
    |October 1, 1984
    PubMed
    Summary

    Surgical correction for double-inlet ventricle is complex. The modified Fontan procedure is feasible in most cases, while ventricular septation is suitable for a subset with two atrioventricular valves.

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    Area of Science:

    • Congenital Heart Surgery
    • Pediatric Cardiology
    • Cardiac Morphology

    Background:

    • Double-inlet ventricle is a rare congenital heart defect.
    • Surgical management options include ventricular septation and the Fontan procedure.
    • Assessing the feasibility of these procedures based on cardiac morphology is crucial.

    Purpose of the Study:

    • To evaluate the surgical feasibility of ventricular septation versus the modified Fontan procedure in 32 cases of double-inlet ventricle.
    • To correlate surgical options with specific cardiac morphological features.

    Main Methods:

    • Sequential segmental analysis of 32 hearts with double-inlet ventricle.
    • Morphological assessment to determine suitability for ventricular septation or modified Fontan procedure.

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    Main Results:

    • The modified Fontan procedure was deemed feasible in 20 out of 32 cases.
    • Ventricular septation was possible in only 13 cases, primarily those with two atrioventricular valves.
    • In cases with a common atrioventricular valve, particularly with right atrial isomerism, ventricular septation was not feasible; the Fontan procedure was considered.
    • Seven cases with a common atrioventricular valve and right atrial isomerism were suitable for a combined Fontan and atrial septation procedure.

    Conclusions:

    • The modified Fontan procedure appears to be a more broadly applicable surgical option for double-inlet ventricle from a morphological standpoint.
    • Ventricular septation remains a viable option for a specific subgroup of patients with double-inlet ventricle and two atrioventricular valves.
    • Careful morphological assessment is essential for selecting the optimal surgical strategy in complex congenital heart disease.