JTCS St. Jude Medical
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Razzouk, A. J.
Right arrow Articles by Rebeyka, I. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Razzouk, A. J.
Right arrow Articles by Rebeyka, I. M.

The Journal of Thoracic and Cardiovascular Surgery, Vol 104, 938-944, Copyright © 1992 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

The recognition, identification of morphologic substrate, and treatment of subaortic stenosis after a Fontan operation. An analysis of twelve patients

AJ Razzouk, RM Freedom, AJ Cohen, WG Williams, GA Trusler, JG Coles, PE Burrows and IM Rebeyka
Division of Cardiology, Hospital for Sick Children, Toronto, Ontario, Canada.

Twelve children were identified with subaortic stenosis after Fontan's operation. All had absent resting and isoproterenol-provoked pressure gradient before the Fontan procedure. Six had a univentricular heart of left ventricular morphology, three had a single ventricle of right ventricular morphology, one had tricuspid atresia with transposition of the great arteries, one had pulmonary atresia, intact ventricular septum, and hypoplastic right ventricle, and one had corrected transposition with hypoplastic systemic ventricle. The median interval between the Fontan operation and the recognition of subaortic stenosis was 2.5 years. Ten patients underwent surgical treatment after a prior Fontan operation: Five had myectomy and enlargement of ventricular septal defect with two operative deaths; two had placement of a valved conduit from the ventricular apex to the descending aorta, and both died postoperatively; two with single ventricle had subaortic myectomy, and one had enlargement of ventricular septal defect and pulmonary aortic connection. Complete heart block developed in only one patient. Postoperative testing with Doppler echocardiography with color flow imaging demonstrated good relief of subaortic stenosis. All six children who survived the operation are well 4 months to 4 years later. Subaortic stenosis is a progressive lesion that may develop after a Fontan operation. Its surgical treatment continues to carry a significant mortality. Myectomy and enlargement of ventricular septal defect achieve direct relief of the obstruction with minimal risk of heart block.


This article has been cited by other articles:


Home page
 Ann. Thorac. Surg.Home page
H. Uemura, S. Y. Ho, I. Adachi, and T. Yagihara
Morphologic spectrum of ventriculoarterial connection in hearts with double inlet left ventricle: implications for surgical procedures.
Ann. Thorac. Surg., October 1, 2008; 86(4): 1321 - 1327.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
J.-H. Yang, T.-G. Jun, P. W. Park, K. Sung, W. S. Kim, Y. T. Lee, J. Huh, and I-S. Kang
Exclusion of the non-functioning right ventricle in children with pulmonary atresia and intact ventricular septum
Eur. J. Cardiothorac. Surg., February 1, 2008; 33(2): 251 - 256.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
D. Kalfa, O. Ghez, B. Kreitmann, and D. Metras
Secondary subaortic stenosis in heart defects without any initial subaortic obstruction: a multifactorial postoperative event
Eur. J. Cardiothorac. Surg., October 1, 2007; 32(4): 582 - 587.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
Y.-T. Lan, R.-K. Chang, and H. Laks
Outcome of patients with double-inlet left ventricle or tricuspid atresia with transposed great arteries
J. Am. Coll. Cardiol., January 7, 2004; 43(1): 113 - 119.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
T. Miura, H. Kishimoto, H. Kawata, M. Hata, T. Hoashi, and T. Nakajima
Management of univentricular heart with systemic ventricular outflow obstruction by pulmonary artery banding and Damus-Kaye-Stansel operation
Ann. Thorac. Surg., January 1, 2004; 77(1): 23 - 28.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
P. E. F. Daubeney, D. J. Delany, R. H. Anderson, G. G. S. Sandor, Z. Slavik, B. R. Keeton, S. A. Webber, and for the United Kingdom and Ireland Collaborative S
Pulmonary atresia with intact ventricular septum: Range of morphology in a population-based study
J. Am. Coll. Cardiol., May 15, 2002; 39(10): 1670 - 1679.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
M. Jahangiri, I. A. Nicholson, P. J. del Nido, J. E. Mayer, and R. A. Jonas
Surgical management of complex and tunnel-like subaortic stenosis
Eur. J. Cardiothorac. Surg., June 1, 2000; 17(6): 637 - 642.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
J. Rychik, H. Levy, J. W. Gaynor, W. M. DeCampli, and T. L. Spray
OUTCOME AFTER OPERATIONS FOR PULMONARY ATRESIA WITH INTACT VENTRICULAR SEPTUM
J. Thorac. Cardiovasc. Surg., December 1, 1998; 116(6): 924 - 931.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
R. M. Freedom
Subaortic obstruction and the fontan operation
Ann. Thorac. Surg., August 1, 1998; 66(2): 649 - 652.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
R. M. Freedom, D. Nykanen, and L. N. Benson
The physiology of the bidirectional cavopulmonary connection
Ann. Thorac. Surg., August 1, 1998; 66(2): 664 - 667.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
D. B. McElhinney, V. M. Reddy, N. H. Silverman, and F. L. Hanley
MODIFIED DAMUS-KAYE-STANSEL PROCEDURE FOR SINGLE VENTRICLE, SUBAORTIC STENOSIS, AND ARCH OBSTRUCTION IN NEONATES AND INFANTS: MIDTERM RESULTS AND TECHNIQUES FOR AVOIDING CIRCULATORY ARREST
J. Thorac. Cardiovasc. Surg., November 1, 1997; 114(5): 718 - 726.
[Abstract] [Full Text]

Home page
 Ann. Thorac. Surg.Home page
H. K. Najm, W. G. Williams, J. G. Coles, I. M. Rebeyka, and R. M. Freedom
Pulmonary Atresia With Intact Ventricular Septum: Results of the Fontan Procedure
Ann. Thorac. Surg., March 1, 1997; 63(3): 669 - 675.
[Abstract] [Full Text]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
R. Kaulitz, G. Ziemer, I. Luhmer, and H.-C. Kallfelz
MODIFIED FONTAN OPERATION IN FUNCTIONALLY UNIVENTRICULAR HEARTS: PREOPERATIVE RISK FACTORS AND INTERMEDIATE RESULTS
J. Thorac. Cardiovasc. Surg., September 1, 1996; 112(3): 658 - 664.
[Abstract] [Full Text]

Home page
 Ann. Thorac. Surg.Home page
A. Serraf, S. Conte, F. Lacour-Gayet, J. Bruniaux, M. Sousa-Uva, R. Roussin, and C. Planche
Systemic Obstruction in Univentricular Hearts: Surgical Options for Neonates
Ann. Thorac. Surg., October 1, 1995; 60(4): 970 - 976.
[Abstract] [Full Text]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
T. Akiba and A. E. Becker
Disease of the left ventricle in pulmonary atresia with intact ventricular septumThe limiting factor for long-lasting successful surgical intervention?
J. Thorac. Cardiovasc. Surg., July 1, 1994; 108(1): 1 - 8.
[Abstract] [Full Text]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 1992 by The American Association for Thoracic Surgery.