Left ventricular apical-abdominal aortic conduits for left ventricular outflow tract obstructions. Clinical results...

Cardiologists and surgeons are occasionally faced with therapeutic dilemmas regarding the management of recurrent left ventricular outflow tract obstructions, such as supravalvular, valvular, subvalvular or "tunnel" stenoses and obstructive myopathies. Following an extended series of biomaterial, hemodynamic, reliability and configuration studies in calves, we have created double-outlet left ventricles in 11 patients. All gradients were markedly reduced. All patients were discharged without anticoagulants, and the longest follow-up period is in excess of 1 year. In eight cases, the percent of cardiac output flowing antegrade and retrograde was quantitated with velocity-tipped catheters. An average ratio of 2:1 (antegrade [ascending aorta]: retrograde [composite conduit]) was found. The procedure is simple and effective in relieving primary or recurrent left ventricular outflow tract obstructions.