Modified Lecompte procedure for the anomalies of ventriculoarterial connection

Citation
Yj. Kim et al., Modified Lecompte procedure for the anomalies of ventriculoarterial connection, ANN THORAC, 72(1), 2001, pp. 176-180
Citations number
17
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiovascular & Respiratory Systems","Medical Research Diagnosis & Treatment
Journal title
ANNALS OF THORACIC SURGERY
ISSN journal
0003-4975 → ACNP
Volume
72
Issue
1
Year of publication
2001
Pages
176 - 180
Database
ISI
SICI code
0003-4975(200107)72:1<176:MLPFTA>2.0.ZU;2-D
Abstract
Background. The Lecompte procedure for correcting transposition of the grea t arteries has an advantage because it obviates the need for an extracardia c conduit for the reconstruction of the pulmonary outflow tract. In this st udy, we evaluated the effectiveness and the application of the Lecompte pro cedure based on our experiences. Methods. A retrospective review was conducted of the records of 45 patients who underwent the Lecompte procedure during the past 11 years to achieve d irect right ventricle to pulmonary artery continuity. Mean age at operation was 2.4 +/- 1.7 years (range 3.5 months to 6.9 years). The diagnoses invol ved anomalies of the ventriculoarterial connection with ventricular septal defect and pulmonary outflow tract obstruction, such as transposition of th e great arteries, double-outlet right ventricle, and double-outlet left ven tricle. Results. Early mortality was 4.4% (2 of 45 patients) and late mortality was 4.7% (2 of 43). The mean follow-up was 4.9 +/- 3.1 years. Fourteen patient s (34.1% of survivors, n = 41) had pulmonary stenosis (pressure gradient ab ove 30 mm Hg), the main reason for which was a calcified monocusp valve (n = 10, 71.4%). Eight of 45 patients (17.8%) underwent reoperation: 2 for res idual ventricular septal defect, 1 for recurrent septic vegetation, and 5 f or pulmonary stenosis. The cumulative survival rates were 91.1% +/- 4.2% at 10 years. The actuarial probabilities of freedom from reoperation for pulm onary stenosis were 93.8% +/- 4.3% and 71.4% +/-. 11.8% at Ei and 10 years, respectively. Conclusions. Our review suggests that the Lecompte procedure is an effectiv e treatment modality for anomalies of the ventriculoarterial connection wit h ventricular septal defect and pulmonary outflow tract obstruction. Repair in early age is possible with acceptable morbidity and mortality, but recu rrent right ventricular outflow tract obstruction caused by degeneration of the monocusp valve is a problem that needs resolution. (C) 2001 by The Soc iety of Thoracic Surgeons.