Thorac Cardiovasc Surg 2007; 55 - V_42
DOI: 10.1055/s-2007-967322

Early results of biventricular repair for HLHC or severe aortic hypoplasia with ventricular septal defect

F Haas 1, J Evens 1, M Freund 1, J Strengers 2
  • 1Wilhelmina Children's Hospital, Pediatric Cardiothoracic Surgery, Utrecht, Netherlands
  • 2Wilhelmina Children's Hospital, Pediatric Cardiology, Utrecht, Netherlands

Aims: Patients with hypoplastic left heart complex (HLHC) and those with severe aortic hypoplsia and VSD (Aohy/VSD) may be candidates for biventricular repair.

Methods: Since July 2004, 4 patients with HLHC and 4 with Aohy/VSD underwent biventricular repair. Z-value for MV and AoV ranged from –3 and –4.5 for HLHC, whereas patients with Aohy/VSD had annular diameters 3mm or smaller. Repair for HLHC consisted of patch aortoplasty of the aortic arch and ascending aorta with ASD fenestration. Two patients additionally underwent unroofing coronary sinus. Repair for Aohy/VSD consisted of a Norwood-Rastelli procedure as a single-stage approach in 3 patients.

Results: Hospital survival was 100%. At shortterm follow-up, no late mortality occurred. Reoperation has been necessary in four patients. In HLHC patients, reasons for reoperation were supravalvular mitral ring stenosis, supravalvular aortic stenosis, recoarctation and in one patient with Aohy/VSD systemic venous stenosis. Clinical condition of all patients is good.

Conclusions: We have successfully achieved biventricular repair in a difficult subset of patients. These results supporting our policy to preserve biventricular physiology when possible.