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Date Published: 26/08/2022
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DOI: https://doi.org/10.51298/vmj.v517i2.3252
Issue
Vol. 517 No. 2 (2022)
Section
Các bài báo
How to Cite
Lý Thịnh Trường, N. ., & Vương Anh, D. . (2022). PRIMARY OUTCOMES OF SINGLE-STAGE BIVENTRICULAR REPAIR FOR AORTIC ARCH OBSTRUCTION-VENTRICULAR SEPTAL DEFECT WITH LEFT VENTRICULAR OUTFLOW TRACT OBSTRUCTION AT NATIONAL CHILDREN’S HOSPITAL. Vietnam Medical Journal, 517(2). https://doi.org/10.51298/vmj.v517i2.3252

PRIMARY OUTCOMES OF SINGLE-STAGE BIVENTRICULAR REPAIR FOR AORTIC ARCH OBSTRUCTION-VENTRICULAR SEPTAL DEFECT WITH LEFT VENTRICULAR OUTFLOW TRACT OBSTRUCTION AT NATIONAL CHILDREN’S HOSPITAL

Nguyễn Lý Thịnh Trường1,, Doãn Vương Anh1
1 Children Heart Center, Vietnam National Children's Hospital

Main Article Content

Abstract

Objective: Evaluation of the early results of single-stage biventricular repair, which includes aortic arch reconstruction, ventricular septal defect closure and release of the left ventricular outflow tract obstruction. Methods: From December 2013 to October 2020, all patients diagnosed with aortic arch obstruction, ventricular septal defect and left ventricular outflow tract obstruction who underwent single-stage biventricular repair were retrospectively studied. Results: There were 43 patients who underwent single-stage repair combined with left ventricular outflow tract obstruction release. The median age at operation was 37 days (IQR, 22-62), and median weight was 3.7kg (IQR, 3.2-4.1). There were 29 males (67.4%) and 14 females. The mean time of aortic cross-clamp time was 98.7 ± 26.3 minutes, the mean time of bypass was 135.6 ± 41.5 minutes, and the mean time of regional cerebral perfusion was 32 ± 11.2 minutes. There were 18 patients (41.9%) who underwent conal septum resection, and 25 patients who underwent placement of the superior border of the ventricular septal defect patch to the left side of the conal septum, in order to release the left ventricular outflow tract obstruction. No patient suffered from aortic valve injury or complete atrioventricular block requiring permanent pacemaker implantation. Two patients required extracorporeal oxygenation membrane support postoperative. There were 2 early deaths (4.7%) and 1 late death (2.3%), and the overall mortality was 7%. There were 2 patients (5%) who required reoperation due to recurrent left ventricular outflow tract obstruction during follow-up, and 1 patient (2.5%) need balloon angioplasty for aortic valve stenosis during the follow-up time of 1.5 years (IQR, 0.6-4). The overall survival and the survival without reoperation at 7-year were 88.5% and 88.5%, respectively.

Article Details

Keywords

coarctation of the aorta, ventricular septal defect, left ventricular outflow tract obstruction, single-stage biventricular repair

References

1. Truong NLT, Mai NT, Vinh TQ, Anh DV, Duyen MD. Single-stage repair for coarctation with ventricular septal defect: results of 100 cases at a single centre. Interact Cardiovasc Thorac Surg. 2020 Oct 1;31(4):559–64.
2. Jijeh A, Ismail M, Alhabshan F. Growth of left ventricular outflow tract and predictors of future re-intervention after repair for ventricular septal defect and aortic arch obstruction. Cardiol Young. 2017 Sep;27(7):1323–8.
3. Gaynor JW, Wernovsky G, Rychik J, Rome JJ, DeCampli WM, Spray TL. Outcome following single-stage repair of coarctation with ventricular septal defectq. Thorac Surg. 2000;6.
4. Sugiura J, Nakano T, Kado H. Left Ventricular Outflow Tract Obstruction in Aortic Arch Anomalies With Ventricular Septal Defect. Ann Thorac Surg. 2016 Jun;101(6):2302–8.
5. (first)Bove EL, Minich LL, Pridjian AK, Lupinetti FM, Snider AR, Dick M 2nd, Beekman RH 3rd. The management of severe subaortic stenosis, ventricular septal defect, and aortic arch obstruction in the neonate. J Thorac Cardiovasc Surg. 1993 Feb;105(2):289-95; discussion 295-6. PMID: 8429657.
6. Luciani GB, Ackerman RJ, Chang AC, Wells WJ, Starnes VA. One-stage repair of interrupted aortic arch, ventricular septal defect, and subaortic obstruction in the neonate: A novel approach. J Thorac Cardiovasc Surg. 1996 Feb;111(2):348–58.
7. Mallios DN, Gray WH, Cheng AL, Wells WJ, Starnes VA, Kumar SR. Biventricular Repair in Interrupted Aortic Arch and Ventricular Septal Defect With a Small Left Ventricular Outflow Tract. Ann Thorac Surg. 2021 Feb;111(2):637–44.
8. Kanter KR, Kirshbom PM, Kogon BE. Biventricular Repair With the Yasui Operation (Norwood/Rastelli) for Systemic Outflow Tract Obstruction With Two Adequate Ventricles. Ann Thorac Surg. 2012 Jun;93(6):1999–2006.
9. Hickey EJ, Yeh Jr. T, Jacobs JP, Caldarone CA, Tchervenkov CI, McCrindle BW, et al. Ross and Yasui operations for complex biventricular repair in infants with critical left ventricular outflow tract obstruction☆. Eur J Cardiothorac Surg. 2009 Sep 17;S1010794009007696.