The impact of the length between the top of the interventricular septum and the aortic valve on the indications for a biventricular repair in patients with a transposition of the great arteries or a double outlet right ventricle

Yasuhiro Fujii, Yasuhiro Kotani, Masami Takagaki, Sadahiko Arai, Shingo Kasahara, Shin ichi Otsuki, Shunji Sano

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

The purpose of this study was to establish a useful cut-off level for performing an original Rastelli-type operation in patients with transposition of the great arteries (TGA)/ventricular septal defect (VSD) or double outlet right ventricle (DORV). A total of 43 patients with TGA/VSD or DORV who underwent an original Rastelli-type operation in this institute between March 1993 and January 2009 were reviewed retrospectively. These patients were divided into two groups using the length between the top of the interventricular septum and the aortic valve (IVS-AV length); Group A; IVS-AV length <80% of normal left ventricular end-diastolic diameter (LVDd). Group B; IVS-AV length >80% of normal LVDd. Group A had a significantly better survival than Group B (100% vs. 56%, P=0.001). The cardiac event-free survival were 89.1% at 7.2 years in Group A and 26.3% at 8.4 years in Group B (P<0.0001). The Group B had a higher incidence of left ventricular outflow tract obstruction (LVOTO; 3% vs. 33%, P=0.02). The IVS-AV length was found to be a significant risk factor for mortality and LVOTO. The IVS-AV length should, therefore, be taken into consideration when selecting the optimal surgical procedures for these patients.

Original languageEnglish
Pages (from-to)900-905
Number of pages6
JournalInteractive cardiovascular and thoracic surgery
Volume10
Issue number6
DOIs
Publication statusPublished - Jun 1 2010

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Keywords

  • Cardiac surgical procedures
  • Double outlet right ventricle
  • Left ventricular outflow obstruction
  • Transposition of great vessels
  • Ventricular septal defect

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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