- Meeting abstract
- Open Access
Repair for the Anomalies of Ventriculoarterial Connection with Ventricular Septal Defect and Left Ventricular Outflow Tract Obstruction
© Kim et al. 2015
- Published: 16 December 2015
- Left Ventricle
- Anatomical Characteristic
- Ventricular Septal Defect
- Ventricular Septal Defect
- Ventricular Outflow Tract
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.
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.
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).
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).
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.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.