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  • Meeting abstract
  • Open Access

Repair for the Anomalies of Ventriculoarterial Connection with Ventricular Septal Defect and Left Ventricular Outflow Tract Obstruction

  • 1,
  • 1 and
  • 1
Journal of Cardiothoracic Surgery201510 (Suppl 1) :A83

https://doi.org/10.1186/1749-8090-10-S1-A83

  • Published:

Keywords

  • Left Ventricle
  • Anatomical Characteristic
  • Ventricular Septal Defect
  • Ventricular Septal Defect
  • Ventricular Outflow Tract

Background/Introduction

Anomalies of ventriculoarterial connection with ventricular septal defect (VSD) and left ventricular outflow tract (LVOT) obstruction such as transposition of the great arteries, double-outlet right ventricle, double-outlet left ventricle, and Taussig-Bing anomaly had a wide variety of spectrum, and several operative techniques have been performed according to diverse anatomical characteristics without standard operative selection guidelines.

Aims/Objectives

This study was undertaken to compare the outcomes of the Lecompte procedure and Rastelli repair in anomalies of ventriculoarterial connection with VSD and LVOT obstruction.

Method

Over a 35-year period (1979- 2014), 95 patients underwent complete repair for anomalies of ventriculoarterial connection with VSD and LVOT obstruction. Fifty patients (52.6%) underwent the Lecompte modification, and median age and weight were 1.95 years (range: 0.30-12.48) and 10.1 kg (range: 5.7-35). Forty five patients (47.4%) underwent the Rastelli operation, and median age and weight were 3.25 years (range: 0.36-46.15) and 13.0 kg (range: 5.9-55).

Results

There were thirteen deaths after complete repair. Twenty three (46.0%) patients in the Lecompte group underwent reoperation, and thirty three (73.3%) in the Rastelli group underwent reoperation. Freedom from reoperation was 25.2 ± 9.4% at 25 years in the Lecompte group and 5.5 ± 4.8% at 27 years in the Rastelli group (p = 0.01). Freedom from reoperation for right ventricular outflow tract (RVOT) obstruction was 49.6 ± 9.0% at 25 years in the Lecompte group and 6.8 ± 5.8% at 27 years in the Rastelli group (p = 0.01). Freedom from reoperation for LVOT obstruction was 88.5 ± 5.4% at 25 years in the Lecompte group and 60.7 ± 10.4% at 33 years in the Rastelli group (p = 0.01).

Discussion/Conclusion

The Lecompte procedure and Rastelli repair provide satisfactory results at long-term follow-up. Substantial late morbidity is more associated with RVOT obstruction, and LVOT obstruction in Rastelli repair rather than Lecompte procedure.

Authors’ Affiliations

(1)
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Korea

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