Predicting Feasibility of Biventricular Repair of Right-Dominant Unbalanced Atrioventricular Canal

Son, Jacques A.M. van; Phoon, Colin K.L.; Silverman, Norman H.; Haas, Gary S.

doi:10.1016/s0003-4975(97)00230-0

Cited by 78 publications

(51 citation statements)

References 12 publications

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“…In the cath group, one patient with Down's syndrome was diagnosed as having right-dominant unbalanced atrioventricular canal, with the preoperative indexed potential left ventricular volume of 17 mL/m 2 . Biventricular repair was attempted according to the suggestion that preoperative indexed potential left ventricular volume of >15 mL/ m 2 allows biventricular repair (19), however, he succumbed to low cardiac output after operation.…”

Section: Resultsmentioning

confidence: 99%

Pediatric Cardiac Surgery with Echocardiographic Diagnosis Alone

2002

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The diagnostic accuracy of echocardiography alone and the safety of cardiac surgery using this diagnostic approach were retrospectively assessed in 111 children operated for congenital heart defects (CHD) during a 3.5-yr period ending in October 2001. Preoperative diagnosis was compared with the intraoperative findings obtained by surgical inspection. Perioperative death was defined as death within 30 days postoperatively. Of the patients, 70% were operated on in infancy. Seventy-six percent (84 of 111) underwent surgery after echocardiographic diagnosis alone. A high percentage of patients with patent ductus arteriosus (100%), partial atrioventricular canal (100%), coarctation of the aorta (89%), ventricular septal defect (86%), atrial septal defect (85%), and total anomalous pulmonary venous connection (75%) was operated without prior catheterization. Diagnostic errors occurred in 2.4% (2 of 84) of patients with echocardiography only and in 7.4% of patients with catheterization. No error in either group was related to surgical morbidity or mortality. There were five (6.0%) perioperative deaths in the echocardiography group and two (7.4%) in the catheterization group, with no difference in the mortality between the groups. In conclusion, many patients with CHD can be accurately diagnosed by echocardiography alone, and can safely undergo surgery without catheterization, not increasing the overall risk.

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Section: Resultsmentioning

confidence: 99%

Pediatric Cardiac Surgery with Echocardiographic Diagnosis Alone

2002

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“…With echocardiographic parameters predicting a successful twoventricular repair [4,11], this surgical approach was carried out at 17 days of age. Bilateral left atrial appendages were noted.…”

Section: Case Reportmentioning

confidence: 99%

“…Holter monitoring confirmed the relative atrial bradycardia with an average heart rate of 113 beats/min and junctional escape rates as low as 62 beats/min. Abdominal ultrasound showed a single, normally placed spleen, and an upper GI series revealed malrotation of the intestines.With echocardiographic parameters predicting a successful twoventricular repair [4,11], this surgical approach was carried out at 17 days of age. Bilateral left atrial appendages were noted.…”

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confidence: 99%

Doppler Echocardiography with Extended Transesophageal Atrial Pacing: Predicting the Efficacy of Permanent Atrial Pacing in the Patient with a Small Left Ventricle and Sinus Node Dysfunction

et al. 1999

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A 2100-g neonate underwent a two-ventricular surgical repair of a right ventricle-dominant unbalanced atrioventricular septal defect associated with the heterotaxy syndrome and sinus node dysfunction. Postoperative congestive heart failure persisted despite bradycardia management by temporary ventricular pacing. Spectral Doppler echocardiographic analysis of pulmonary venous inflow and aortic outflow patterns demonstrated significant improvement with transesophageal atrial pacing. Extended transesophageal pacing was performed for two days, resulting in dramatic clinical improvement. This is the first report of extended transesophageal atrial pacing complementing Doppler echocardiography predicting an improved outcome with permanent atrial pacing.

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“…There are as yet no proven guidelines for deciding between biventricular repair and univentricular palliation [1,2], and more than one strategy has been suggested [3][4][5][6][7][8][9]. Cohen and Rychik [1] reported a large group of patients with unbalanced AVSD, wherein they used echocardiographic measurements of atrioventricular valve index (AVVI) which is left valve area divided by right valve area.…”

Section: Introductionmentioning

confidence: 99%

“…However, the definition of ventricular hypoplasia as determined preoperatively remains unclear, and mainly criteria that have been applied to other conditions with small left ventricles are used [11]. Univentricular palliation is mostly performed to correct unbalanced CAVSD with hypoplastic left ventricle [2,8,10]. We believe that biventricular repair, if feasible, remains a satisfactory option.…”

Section: Introductionmentioning

confidence: 99%

Biventricular repair in children with complete atrioventricular septal defect and a small left ventricle☆

Walter

Ewert

Hetzer

et al. 2008

European Journal of Cardio-Thoracic Surgery

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Biventricular repair of CAVSD with small left ventricle in infants and children whose LAR is >0.65, although not without risks, improve patients' functional and clinical status even in long-term follow-up. Particular caution should be taken in patients with LAR of <0.65, since these are patients who may not be amenable to biventricular repair, but for whom univentricular palliation may be more suitable.

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Predicting Feasibility of Biventricular Repair of Right-Dominant Unbalanced Atrioventricular Canal

Cited by 78 publications

References 12 publications

Pediatric Cardiac Surgery with Echocardiographic Diagnosis Alone

Pediatric Cardiac Surgery with Echocardiographic Diagnosis Alone

Doppler Echocardiography with Extended Transesophageal Atrial Pacing: Predicting the Efficacy of Permanent Atrial Pacing in the Patient with a Small Left Ventricle and Sinus Node Dysfunction

Biventricular repair in children with complete atrioventricular septal defect and a small left ventricle☆

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