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[Correction of double-outlet right ventricle using the Kawashima intraventricular tunnel procedure]
Insights
Anatomical intraventricular tunnel repair significantly improves outcomes for children with double-outlet right ventricle. This surgical approach restores normal heart circulation, enhancing long-term prognosis and quality of life.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Surgery
- Cardiac Anatomy
Context:
- Double-outlet right ventricle (DORV) presents complex surgical challenges.
- Intraventricular tunnel repair is a specialized technique for DORV.
- Previous palliative surgeries were common in the study cohort.
Purpose:
- To evaluate the efficacy and outcomes of anatomical intraventricular tunnel correction in pediatric patients with double-outlet right ventricle.
- To assess the impact of this surgical strategy on cardiac function and long-term prognosis.
Summary:
- Fourteen children with double-outlet right ventricle and ventricular septal defects underwent anatomical intraventricular tunnel repair.
- Complications included residual defects, infectious endocarditis, and arrhythmias.
- Most patients experienced improved performance and were free from symptoms at medium- to long-term follow-up.
Impact:
- Anatomical intraventricular correction successfully reroutes the left ventricle and mitral valve to the systemic circulation.
- The study demonstrates a substantial improvement in prognosis for children with DORV and specific VSD types.
- This surgical technique offers a promising option for managing complex congenital heart disease.
Abstract:
Anatomical correction with an intraventricular tunnel, as suggested by Kawashima, was performed in 14 children with a double-outlet right ventricle and a subpulmonary (4) or non-committed (10) defect of the ventricular septum with one early and one late death. Nine children had previous palliative operations. Complications after radical surgery were residual ventricular defects (4), infectious endocarditis (2) and impaired rhythm (one sudden death). Twelve patients are after medium- term or long-term follow-up free from subjective complaints, ten children report good performance, in two the performance is slightly reduced. Anatomical intraventricular correction of double-outlet right ventricle restores the mitral valve and left ventricle to the systemic circulation. The prognosis of children with double-outlet right ventricle and subpulmonary or remote ventricular defect improves substantially.