One-and-a-Half Ventricle Repair in Adult Patients: A Word of Caution

Objectives The “one‐and‐a‐half ventricle repair” (1.5 VR) is applied to several congenital heart diseases with hypoplastic right ventricle (RV), with good functional and clinical results in infants and children, but feasibility in adult population is being explored. Materials and Methods This is a r...

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Bibliographic Details
Published in:Journal of cardiac surgery 2014-07, Vol.29 (4), p.542-545
Main Authors: Padalino, M., Carrozzini, M., Vida, V., Stellin, G.
Format: Article
Language:English
Subjects:
Adult
Age Factors
Aged
Anticoagulants - administration & dosage
Cardiac Surgical Procedures - methods
Cardiac Surgical Procedures - mortality
Chronic Disease
Comorbidity
Feasibility Studies
Female
Follow-Up Studies
Heart Defects, Congenital - diagnosis
Heart Defects, Congenital - mortality
Heart Defects, Congenital - physiopathology
Heart Defects, Congenital - surgery
Heart Ventricles - surgery
Humans
Male
Middle Aged
Postoperative Care
Retrospective Studies
Survival Rate
Time Factors
Treatment Outcome
Vascular Resistance
Ventricular Dysfunction, Right
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Summary:Objectives The “one‐and‐a‐half ventricle repair” (1.5 VR) is applied to several congenital heart diseases with hypoplastic right ventricle (RV), with good functional and clinical results in infants and children, but feasibility in adult population is being explored. Materials and Methods This is a retrospective analysis of medical records of all adult patients undergoing 1 + 1/5 VR between 2000 and 2012. Results Five patients (M/F = 4/1, mean age of 42.3 years, range 29–66.8) underwent 1 + 1/5 VR. Underlying diagnoses were Ebstein's anomaly (EA) in three, hypoplastic RV and tricuspid valve (TV) in two. Mean TV annulus Z‐score was −3.0; mean pulmonary vascular resistance was 1.6 WU/m2. Eleven associated procedures were performed simultaneously to 1.5 VR. There were no operative deaths. All patients were discharged home alive and in good clinical condition on anticoagulation regimen. At a mean follow‐up of 8.6 ± 5.2 years, there was one cerebral stroke‐related death; two patients experienced major complications. Two patients are in NYHA Class I, one is in NYHA Class II, and the last in NYHA Class III on a transplant list. Conclusions The one‐and‐a‐half ventricle repair in adult patients is feasible with low mortality. However, advanced age‐associated co‐morbidities and prolonged chronic RV preoperative dysfunction may jeopardize long‐term results when compared to children. doi: 10.1111/jocs.12350 (J Card Surg 2014;29:542–545)
ISSN:0886-0440
1540-8191
DOI:10.1111/jocs.12350