Hostname: page-component-848d4c4894-75dct Total loading time: 0 Render date: 2024-06-01T15:07:26.015Z Has data issue: false hasContentIssue false

Long-term results of biventricular correction for patients with double outlet right ventricle

Published online by Cambridge University Press:  30 August 2022

Zhangwei Wang
Affiliation:
Department of Cardiac Surgery, Beijing Children’s Hospital, Capital Medical University, National Children’s Medical Center, Beijing, China
Zhiqiang Li*
Affiliation:
Department of Cardiac Surgery, Beijing Children’s Hospital, Capital Medical University, National Children’s Medical Center, Beijing, China
*
Author for correspondence: Zhiqiang Li, Department of Cardiac Surgery, Beijing Children’s Hospital, Capital Medical University, 56th Nan Lishi Road, Beijing 100045, China. E-mail: lizhiqianganzhen@yeah.net

Abstract

Objectives:

The purpose of this study was to report outcomes of double outlet right ventricle biventricular repair at a single institution in developing countries and to investigate post-operatively determined risk factors for mortality and late intervention.

Methods:

Patients with double outlet right ventricle who underwent biventricular repair in our centre from January 2009 to December 2021 were included.

Results:

A total of 96 patients (male/female = 61/35) with biventricular repair were included. According to its specific anatomical type, the appropriate individual surgical plan was selected. Multivariate analysis indicated that prolonged cardiopulmonary bypass time(OR = 1.044; p = 0.012) and pre-operative moderate or above pulmonary hypertension(OR = 24.558; p = 0.023) were independent risk factors for early mortality. Univariate analysis showed that different anatomical types and different surgical methods had similar late intervention and late mortality. Concomitant coarctation of the aorta(OR = 40; p = 0.020) and concomitant ventricular septal defect enlargement(OR = 26.667; p = 0.005) were independent risk factors for late intervention by multivariate analysis.

Conclusion:

Selection of appropriate surgical techniques based on different anatomical types often results in similar late outcomes. For patients with concomitant ventricular septal defect enlargement during the operation, it is necessary to fully expand and avoid damage to the conduction bundle. We should timely intervention in patients with coarctation of the aorta and pay attention to the occurrence of left ventricular outflow tract obstruction during follow-up.

Type
Original Article
Copyright
© The Author(s), 2022. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Shoujun, Li. Frontiers in surgical management of double outlet right ventricle: biventricular repair is a preferred strategy. J Clin Ped Sur 2021; 20: 501505. DOI 10.12260.Google Scholar
Walters, HR, Mavroudis, C, Tchervenkov, CI, Jacobs, JP, Lacour-Gayet, F, Jacobs, ML. Congenital heart surgery nomenclature and database project: double outlet right ventricle. ANN THORAC SURG 2000; 69: S249S263.CrossRefGoogle ScholarPubMed
Lacour-Gayet, F, Maruszewski, B, Mavroudis, C, Jacobs, JP, Elliott, MJ. Presentation of the international nomenclature for congenital heart surgery. the long way from nomenclature to collection of validated data at the EACTS. Eur J Cardiothorac Surg 2000; 18: 128135.CrossRefGoogle Scholar
Mavroudis, C, Backer, C, Idriss, RF. Pediatric cardiac surgery. Blackwell, Oxford, 2012.CrossRefGoogle Scholar
Li, S, Ma, K, Hu, S, et al. Biventricular repair for double outlet right ventricle with non-committed ventricular septal defect. Eur J Cardiothorac Surg 2015; 48: 580587, 587.CrossRefGoogle ScholarPubMed
Lu, T, Li, J, Hu, J, et al. Biventricular repair of double-outlet right ventricle with noncommitted ventricular septal defect using intraventricular conduit. J Thorac Cardiovasc Surg 2020; 159: 23972403.CrossRefGoogle ScholarPubMed
Benqing, Zhang, Kai, Ma, Liu Rui, LIShoujun. The efficacy of combined tricuspid management technique in biventricular repair for children with double outlet right ventricle complicating with Non-committed ventricular septal defect. Chinese Circulation Journal 2020; 35: 584587.Google Scholar
Benqing, Zhang, Ma Kai, LIShoujun. Chinese expert consensus on surgical treatment of congenital heart disease (VII) : double outlet of right ventricle. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2020; 27: 851856.Google Scholar
Li, S, Ma, K, Hu, S, et al. Surgical outcomes of 380 patients with double outlet right ventricle who underwent biventricular repair. J Thorac Cardiovasc Surg 2014; 148: 817824.CrossRefGoogle ScholarPubMed
Jiangen, Yu, Baiping, Sun, Lianglong, Ma. Surgical strategy for the children with double-outlet right ventricle: our experience in 118 cases. Chin J Pediatr Surg 2011, 269271.Google Scholar
Villemain, O, Belli, E, Ladouceur, M, et al. Impact of anatomic characteristics and initial biventricular surgical strategy on outcomes in various forms of double-outlet right ventricle. J Thorac Cardiovasc Surg 2016; 152: 698706.CrossRefGoogle ScholarPubMed
Tchervenkov, CI, Marelli, D, Beland, MJ, Gibbons, JE, Paquet, M, Dobell, AR. Institutional experience with a protocol of early primary repair of double-outlet right ventricle. ANN THORAC SURG 1995; 60: S610S613.CrossRefGoogle ScholarPubMed
Yewei, Xie, Rufang, Zhang, Shen, Li, et al. Therapeutic effect of surgical treatment on complex congenital heart disease with double outlet of right ventricle. Chin J Evid Based Cardiovasc Med 2018; 10: 944946.Google Scholar