Long term outcome of ventricular septation for single left ventricle

  • Dr Yusuke Iwata, The Heart Institute of Japan, Tokyo Women's Medical University, Japan
  • Dr Yasuharu Imai, The Heart Institute of Japan, Tokyo Women's Medical University, Japan
  • Dr Kazuaki Ishihara, The Heart Institute of Japan, Tokyo Women's Medical University, Japan
  • Dr Takeshi Konuma, The Heart Institute of Japan, Tokyo Women's Medical University, Japan
  • Dr Yuji Naitoh, The Heart Institute of Japan, Tokyo Women's Medical University, Japan
  • Dr Masahide Komagamine, The Heart Institute of Japan, Tokyo Women's Medical University, Japan
  • Dr Toshio Nakanishi, The Heart Institute of Japan, Tokyo Women's Medical University, Japan
  • Dr Hiromi Kurosawa, The Heart Institute of Japan, Tokyo Women's Medical University, Japan

    • Background
    Ventricular septation is one of surgical options for single left ventricle since bi-ventricular repair is superior to uni-ventricular repair in postoperative cardiac out put. However, long term result is still unclear. The purpose of the current study was to investigate long term outcome of ventricular septation for single left ventricle.

    Methods
    Thirty-five patients, who underwent ventricular septation between 1983 and 2008, were concordant A-V connection in 8 and discordant A-V connection in 27. Twenty-seven patients with discordant A-V connection were studied by retrospective medical record review. Median age was 8.5 (range: 0.3 – 24.8). Mean follow up period was 14.8 (range: 0.4 – 34.6).

    Results
    Four patients died after surgery due to heart failure. There were 6 late deaths including one non-cardiac death. 4 patients died due to right sided heart failure resulting from mitral regurgitation. One patients died suddenly by arrythmia. Actuarial survivals were 76.5% and 59.0% at 10 and 20 years, respectively. Re-operation was performed in 5 patients, 4 of which those patients required mitral valve repair or replacement, and 2 patients required release of subaotic stenosis due to bulvo-ventricular foramen. Degree of mitral regurgitation wasn’t associated with numbers of placed plegdets on the mitral valve and degrees of residual shunt.

    Conclusion
    Long term outcome after ventricular septation was influenced by right sided heart failure due to mitral regurgitation rather than systemic heart failure resulted from tricuspid regurgitation. Early detection and treatment of mitral regurgitation was required for improvement of long term result of ventricular septation.