Surgical and Long Term Results for Double Outlet Right Ventricle by the Type of Ventricular Septal Defect

Yu, Song Hyeon; Park, Young Hwan; Park, Han Ki; Cho, Bum Koo

Abstract

BACKGROUND: The results of biventricular repair for double outlet right ventricle have been improved in recent series. We studied the surgical and long term results for total correction of double outlet right ventricle by the type of ventricular septal defect. MATERIAL AND METHOD: Between November 1979 and December 2003, 126 patients had biventricular repair for double outlet right ventricle. The mean age was 1.8 years (range 1~44) and 86 patients (68.3%) were male. We classified and studied this disease by the type of VSD. RESULT: The locations of VSD were subaortic in 79 (62.7%), subpulmonary in 17 (13.5%), doubly committed in 16 (12.7%) and noncommitted in 14 (11.1%). 28 patients had palliative operation before total correction and the mean interval to total correction was 41.0+/-45.1 months. The methods of total correction were intraventricular baffling in 37 (29.4%), intraventricular baffling with patch enlargement of right ventricular outflow tract in 49 (38.9%), intraventricular baffling with Rastelli procedure in 15 (11.9%), arterial switch operation in 8 (6.3%) and REV procedure in 4 (3.2%), etc. Hospital mortality rate was 10.3% (13 patients) and 25 reoperations were performed in 24 patients (19.0%). The risk factors for hospital mortality and reoperation were cardiopulmonary bypass time (p=0.020) and previous palliative operation (p=0.013), respectively. Follow up was possible in 98 patients and mean follow up period was 118.9+/-70.7 months. The percent survival and survival for freedom from reoperation at 15 years were 82.5% and 66.7%, respectively. The survival rate was significantly lower (p=0.003) in transposition of great artery type and remote type than in simple ventricular septal defect type and tetralogy of Fallot type, but there was no statistical differences in survival rate for freedom from reoperation.
CONCLUSION
It is thought to be that acceptible surgical and long term results can be obtained with application of appropriate methods of repair for double outlet right ventricle.