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J Thorac Cardiovasc Surg 1999;118:1056-1067
© 1999 Mosby, Inc.

SURGERY FOR CONGENITAL HEART DISEASE

INTRAVENTRICULAR REPAIR OF DOUBLE-OUTLET RIGHT VENTRICLE WITH NONCOMMITTED VENTRICULAR SEPTAL DEFECT: ADVANTAGES OF MULTIPLE PATCHES

From the Pediatric Cardiac Surgery Department,^a Department of Cardiac Surgery of the Heart Institute,^b and Department of Pediatric Cardiology,^c University of São Paulo Medical School, São Paulo, Brazil.

Address for reprints: Miguel Barbero-Marcial, Heart Institute, Av Dr Enéas de Carvalho Aguiar, 44, CEP 05403-000, São Paulo, Brazil.

Objective: The objective of this paper is to report our experience with biventricular repair of double-outlet right ventricle with noncommitted ventricular septal defect by means of multiple patches that simplify and render feasible the intraventricular correction of this complex anomaly.
Methods: From April 1987 to April 1999, in 18 patients with double-outlet right ventricle and noncommitted ventricular septal defect, a technical modification that used multiple patches of bovine pericardium was used to construct an intraventricular tunnel connecting the left ventricle to the aorta. Ages ranged from 2 months to 13 years (mean age 4.73 ± 3.41 years).
Results: The early mortality was of 11.1% (2 patients). Surviving patients were followed up for a mean of 2.65 years. Three late deaths (16.6%) occurred: 5 months, 7 months, and 7 months after the operation. All but 1 patient are in New York Heart Association class I.
Conclusion: The use of multiple patches for biventricular correction of this anomaly simplifies and renders feasible the intraventricular repair in cases in which the 1-patch technique was deemed impossible.

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