Apico-Pulmonary Artery Conduit Repair of Congenitally Corrected Transposition of the Great Arteries with Ventricular Septal Defect and Pulmonary Outflow Tract Obstruction: A 10-Year Follow-Up

Ryo Aeba, Toshiyuki Katogi, Kiyoshi Koizumi, Yoshimi Iino, Mitsuharu Mori, Ryohei Yozu, Marshall L. Jacobs, Alex Palacios, Tom R. Karl, Pedro J. Del Nido

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background. In conventional repair of the congenitally corrected transpositions of the great arteries associated with ventricular septal defect and pulmonary outflow tract obstruction, the placement of the left ventricle-pulmonary artery conduit is at risk owing to probable compression by the sternum, heart block, or injury to the mitral anterior papillary muscle. Apical placement of the left ventriculotomy for the inflow conduit rather than in the midportion or base placement may avoid these complications, although this results in a long and winding extracardiac conduit that may be short-lived because of the proliferation of pseudointima. Methods. Between 1985 and 1990, a nonvalved Dacron woven-fabric graft conduit was placed between the left ventricular apex and pulmonary artery in 5 patients (mean age, 6.2 ± 1.7 years) who were then followed for at least 10 years. Results. No iatrogenic heart blocks or mitral regurgitation developed. All patients were complaint-free during the follow-up period, although 1 patient who was clinically well died suddenly in the 10th follow-up year. Cardiac catheterization in the 10th follow-up year indicated a pressure gradient of 21 ± 6 mm Hg across the conduit, and angiography revealed that the conduit diameter was 91% ± 6% of the original conduit diameter. Conclusions. The reportedly poor early and late outcomes that occur after a conventional repair of congenitally corrected transpositions of the great arteries associated with ventricular septal defect and pulmonary outflow tract obstruction, which places an extracardiac conduit between the left ventricle and the pulmonary artery, may be partially neutralized by relocating the inflow position to the apex.

Original languageEnglish
Pages (from-to)1383-1388
Number of pages6
JournalAnnals of Thoracic Surgery
Volume76
Issue number5
DOIs
Publication statusPublished - 2003 Nov

Fingerprint

Ventricular Heart Septal Defects
antineoplaston A10
Pulmonary Artery
Heart Block
Lung
Heart Ventricles
Heart Injuries
Sternum
Polyethylene Terephthalates
Papillary Muscles
Mitral Valve Insufficiency
Cardiac Catheterization
Angiography
Transplants
Pressure
Congenitally corrected transposition of the great arteries

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Apico-Pulmonary Artery Conduit Repair of Congenitally Corrected Transposition of the Great Arteries with Ventricular Septal Defect and Pulmonary Outflow Tract Obstruction : A 10-Year Follow-Up. / Aeba, Ryo; Katogi, Toshiyuki; Koizumi, Kiyoshi; Iino, Yoshimi; Mori, Mitsuharu; Yozu, Ryohei; Jacobs, Marshall L.; Palacios, Alex; Karl, Tom R.; Del Nido, Pedro J.

In: Annals of Thoracic Surgery, Vol. 76, No. 5, 11.2003, p. 1383-1388.

Research output: Contribution to journalArticle

Aeba, Ryo ; Katogi, Toshiyuki ; Koizumi, Kiyoshi ; Iino, Yoshimi ; Mori, Mitsuharu ; Yozu, Ryohei ; Jacobs, Marshall L. ; Palacios, Alex ; Karl, Tom R. ; Del Nido, Pedro J. / Apico-Pulmonary Artery Conduit Repair of Congenitally Corrected Transposition of the Great Arteries with Ventricular Septal Defect and Pulmonary Outflow Tract Obstruction : A 10-Year Follow-Up. In: Annals of Thoracic Surgery. 2003 ; Vol. 76, No. 5. pp. 1383-1388.
@article{172e1a339183400585562844c47660d7,
title = "Apico-Pulmonary Artery Conduit Repair of Congenitally Corrected Transposition of the Great Arteries with Ventricular Septal Defect and Pulmonary Outflow Tract Obstruction: A 10-Year Follow-Up",
abstract = "Background. In conventional repair of the congenitally corrected transpositions of the great arteries associated with ventricular septal defect and pulmonary outflow tract obstruction, the placement of the left ventricle-pulmonary artery conduit is at risk owing to probable compression by the sternum, heart block, or injury to the mitral anterior papillary muscle. Apical placement of the left ventriculotomy for the inflow conduit rather than in the midportion or base placement may avoid these complications, although this results in a long and winding extracardiac conduit that may be short-lived because of the proliferation of pseudointima. Methods. Between 1985 and 1990, a nonvalved Dacron woven-fabric graft conduit was placed between the left ventricular apex and pulmonary artery in 5 patients (mean age, 6.2 ± 1.7 years) who were then followed for at least 10 years. Results. No iatrogenic heart blocks or mitral regurgitation developed. All patients were complaint-free during the follow-up period, although 1 patient who was clinically well died suddenly in the 10th follow-up year. Cardiac catheterization in the 10th follow-up year indicated a pressure gradient of 21 ± 6 mm Hg across the conduit, and angiography revealed that the conduit diameter was 91{\%} ± 6{\%} of the original conduit diameter. Conclusions. The reportedly poor early and late outcomes that occur after a conventional repair of congenitally corrected transpositions of the great arteries associated with ventricular septal defect and pulmonary outflow tract obstruction, which places an extracardiac conduit between the left ventricle and the pulmonary artery, may be partially neutralized by relocating the inflow position to the apex.",
author = "Ryo Aeba and Toshiyuki Katogi and Kiyoshi Koizumi and Yoshimi Iino and Mitsuharu Mori and Ryohei Yozu and Jacobs, {Marshall L.} and Alex Palacios and Karl, {Tom R.} and {Del Nido}, {Pedro J.}",
year = "2003",
month = "11",
doi = "10.1016/S0003-4975(03)01073-7",
language = "English",
volume = "76",
pages = "1383--1388",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier USA",
number = "5",

}

TY - JOUR

T1 - Apico-Pulmonary Artery Conduit Repair of Congenitally Corrected Transposition of the Great Arteries with Ventricular Septal Defect and Pulmonary Outflow Tract Obstruction

T2 - A 10-Year Follow-Up

AU - Aeba, Ryo

AU - Katogi, Toshiyuki

AU - Koizumi, Kiyoshi

AU - Iino, Yoshimi

AU - Mori, Mitsuharu

AU - Yozu, Ryohei

AU - Jacobs, Marshall L.

AU - Palacios, Alex

AU - Karl, Tom R.

AU - Del Nido, Pedro J.

PY - 2003/11

Y1 - 2003/11

N2 - Background. In conventional repair of the congenitally corrected transpositions of the great arteries associated with ventricular septal defect and pulmonary outflow tract obstruction, the placement of the left ventricle-pulmonary artery conduit is at risk owing to probable compression by the sternum, heart block, or injury to the mitral anterior papillary muscle. Apical placement of the left ventriculotomy for the inflow conduit rather than in the midportion or base placement may avoid these complications, although this results in a long and winding extracardiac conduit that may be short-lived because of the proliferation of pseudointima. Methods. Between 1985 and 1990, a nonvalved Dacron woven-fabric graft conduit was placed between the left ventricular apex and pulmonary artery in 5 patients (mean age, 6.2 ± 1.7 years) who were then followed for at least 10 years. Results. No iatrogenic heart blocks or mitral regurgitation developed. All patients were complaint-free during the follow-up period, although 1 patient who was clinically well died suddenly in the 10th follow-up year. Cardiac catheterization in the 10th follow-up year indicated a pressure gradient of 21 ± 6 mm Hg across the conduit, and angiography revealed that the conduit diameter was 91% ± 6% of the original conduit diameter. Conclusions. The reportedly poor early and late outcomes that occur after a conventional repair of congenitally corrected transpositions of the great arteries associated with ventricular septal defect and pulmonary outflow tract obstruction, which places an extracardiac conduit between the left ventricle and the pulmonary artery, may be partially neutralized by relocating the inflow position to the apex.

AB - Background. In conventional repair of the congenitally corrected transpositions of the great arteries associated with ventricular septal defect and pulmonary outflow tract obstruction, the placement of the left ventricle-pulmonary artery conduit is at risk owing to probable compression by the sternum, heart block, or injury to the mitral anterior papillary muscle. Apical placement of the left ventriculotomy for the inflow conduit rather than in the midportion or base placement may avoid these complications, although this results in a long and winding extracardiac conduit that may be short-lived because of the proliferation of pseudointima. Methods. Between 1985 and 1990, a nonvalved Dacron woven-fabric graft conduit was placed between the left ventricular apex and pulmonary artery in 5 patients (mean age, 6.2 ± 1.7 years) who were then followed for at least 10 years. Results. No iatrogenic heart blocks or mitral regurgitation developed. All patients were complaint-free during the follow-up period, although 1 patient who was clinically well died suddenly in the 10th follow-up year. Cardiac catheterization in the 10th follow-up year indicated a pressure gradient of 21 ± 6 mm Hg across the conduit, and angiography revealed that the conduit diameter was 91% ± 6% of the original conduit diameter. Conclusions. The reportedly poor early and late outcomes that occur after a conventional repair of congenitally corrected transpositions of the great arteries associated with ventricular septal defect and pulmonary outflow tract obstruction, which places an extracardiac conduit between the left ventricle and the pulmonary artery, may be partially neutralized by relocating the inflow position to the apex.

UR - http://www.scopus.com/inward/record.url?scp=0242552210&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0242552210&partnerID=8YFLogxK

U2 - 10.1016/S0003-4975(03)01073-7

DO - 10.1016/S0003-4975(03)01073-7

M3 - Article

C2 - 14602256

AN - SCOPUS:0242552210

VL - 76

SP - 1383

EP - 1388

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 5

ER -