Biventricle Repair of Double Outlet Right Ventricle with Non-Committed Ventricular Septal Defect
Materials and Methods: From Oct 1996 to Jane 2008, twenty patients of DORV with non-committed VSD underwent biventricular repair. The age distribution is from 13 days to 23 years old (Mean 2.8 years old). The sex ratio of male to female is equal. The associate anomalies included pulmonary stenosis and atresia 6,coarctation of aorta 4,straddling of atrioventricular valve 3, ECD 2, juxtaposed atrial appendage 2, LV diverticulum 1, anatomic corrected malposition (ACM) 2, TAPVR 1.Eleven patients had palliative procedure (systemic-pulmonary shunt 4, PA banding 7, CoA repair 4). The definite surgical procedures were performed in 20 patients. The definite surgical procedures divided into two group. Group I, Five patents underwent arterial switch opeation. Three of them had VSD enlargement. Group 2, Fifteen patients underwent intraventricular rerouting procedure thirteen of them had VSD enlargement. Only one had extracardiac conduit.Results:There are three early mortality, 2 in group 1 and 1 in group 2, and no late mortality. All of them are neonates and small infant (≦3 months). The follow-up period was 3 months to 10 years. The postoperative complications are AV block 1, residual LVOTO 3 (pressure gradient<20 mmHg), residual PS 3 (pressure gradient ≦ 45 mmHg) and mitral regurgitation 1.Conclusion:Biventricular repair in feasible in DORV with non-committed VSD and certain anatomical features. Neonatal definite repair will be high risk in our series. Intra- ventricular LVOT rerouting procedure is recommended. Precise preoperative evaluations will determined the type of the definite repair.