scholarly journals Using Medtronic AP360 Mechanical Prosthesis in Mitral Valve Replacement for Patients with Mitral Insufficiency After Primum Atrial Septal Defect Repair to Reduce Left Ventricular Outflow Tract Obstruction Risk

2021 ◽  
Author(s):  
Lei Guo ◽  
Qiqi Yang ◽  
Yu Han ◽  
Junnan Zheng ◽  
Yiming Ni
Keyword(s):  
Atrial Septal Defect ◽  
Congenital Heart ◽  
Septal Defect ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Mitral Insufficiency ◽  
Severe Mitral Regurgitation ◽  
Left Ventricular Outflow

Abstract Background: Atrial septal defect is one of the most common congenital heart diseases in adults. Primum atrial septal defect (PASD) accounts for 4% to 5% of congenital heart defects. Patients with PASD frequently suffer mitral insufficiency, and thus, mitral valvuloplasty (MVP) or mitral valve replacement (MVR) is often required at the time of PASD repair. Unfortunately, recurrent unrepairable severe mitral regurgitation can develop in many patients undergoing PASD repair plus MVP in either short- or long-term after the repair surgery, requiring a re-do MVR. In those patients, risk of left ventricular outflow tract obstruction (LVOTO) has increased.Case presentation: We present 5 such cases who were aged from 24 to 47 years and had a PASD repair plus MVP or MVR for 14 to 40 years, suffering moderate to severe mitral regurgitation. Using Medtronic AP360 mechanical mitral prostheses, only one patient occurred mild LVOTO. Conclusions: Usage of Medtronic AP360 mechanical mitral prostheses to perform MVR in patients with MI who had a PASD repair history can potentially reduce the risk of LVOTO. Long-term follow-up is required to further confirm this clinical benefit associated with AP360 implantation in patients with PASD.

scholarly journals Outcome of modified réparation à l’ètage ventriculaire (REV) based on anatomical characteristics for the anomalous ventriculoarterial connection with ventricular septal defect and left ventricular outflow tract obstruction

2020 ◽  
Vol 31 (5) ◽  
pp. 674-679
Author(s):  
Kang An ◽  
Shengshou Hu ◽  
Shoujun Li ◽  
Jun Yan ◽  
Xu Wang ◽  
...  
Keyword(s):  
Septal Defect ◽  
Left Ventricular Outflow Tract ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Ventricular Outflow Tract Obstruction ◽  
Left Ventricular Outflow ◽  
Peak Gradient

Abstract OBJECTIVES The present study evaluated the results of the modified réparation à l’étage ventriculaire (REV) based on the individual anatomical and pathological findings of the patients with an anomalous ventriculo-arterial connection with ventricular septal defect (VSD) and left ventricular outflow tract obstruction. METHODS We reviewed a series of 24 patients who underwent modified REV between 2005 and 2019. Surgical indications included ventricles and atrioventricular valves suitable for biventricular repair, severe left ventricular outflow tract obstruction (peak gradient >30 mmHg), unrestrictive subaortic VSD and coronary arteries not suitable for reimplantation. RESULTS The mean follow-up time was 7.0 ± 4.2 years (range 0.5–14.1 years). Kaplan–Meier analyses showed that overall survival was 100% and freedom from any reoperation was 93.3% ± 6.4%. Longitudinal analyses of the available postoperative echocardiographic data showed that the left ventricular outflow tract peak gradient was less than 10 mmHg in all patients (15/15) and the left ventricular ejection fraction was more than 50% in 93.3% of patients (14/15). The right ventricular outflow tract peak gradient was less than 40 mmHg in 73.3% of patients (11/15). CONCLUSIONS The REV remains an option for selected patients despite the increasing use in recent years of the Nikaidoh procedure and its modifications. The surgical strategy needs to be determined by the specific anatomical and pathological findings of the patient. The modified REV had excellent long-term survival and freedom from reoperation for the treatment of anomalous ventriculo-arterial connection with VSD and left ventricular outflow tract obstruction. The long-term performance of the reconstructed left ventricular outflow tract and right ventricular outflow tract is satisfactory.

Arterial Switch Operation With Neoaortic Valve Replacement in a 13-Year Old Patient With Transposition of Great Arteries With Ventricular Septal Defect and Left Ventricular Outflow Tract Obstruction—A Case Report

2018 ◽  
Vol 11 (4) ◽  
pp. NP190-NP194
Author(s):  
Kuntal Roy Chowdhuri ◽  
Manoj Kumar Daga ◽  
Subhendu Mandal ◽  
Pravir Das ◽  
Amanul Hoque ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Valve Replacement ◽  
Septal Defect ◽  
Left Ventricular Outflow Tract ◽  
Arterial Switch Operation ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Transposition Of Great Arteries ◽  
Switch Operation ◽  
Left Ventricular Outflow

The surgical management of d-transposition of great arteries (d-TGAs) with ventricular septal defect (VSD) and left ventricular outflow tract obstruction (LVOTO) is ever evolving and still remains a challenge because of wide anatomic variability, age of presentation, surgical options available, and their variable long-term results in different series. We describe a patient with d-TGA, VSD, and LVOTO who presented to us at 13 years of age and underwent an arterial switch operation along with neoaortic valve replacement with a mechanical prosthesis. The postoperative course was uneventful, and at hospital discharge, the echocardiogram was satisfactory. We present the pros and cons of this hitherto undescribed treatment option.

Surgery of the left atrioventricular valve and of the left ventricular outflow tract in atrioventricular septal defect

1991 ◽  
Vol 1 (4) ◽  
pp. 344-355 ◽  
Author(s):  
Tjark Ebles
Keyword(s):  
Septal Defect ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Atrioventricular Septal Defect ◽  
Left Ventricular ◽  
Atrioventricular Valve ◽  
Left Ventricular Outflow ◽  
Cardiac Surgeon ◽  
The Individual ◽  
And Function

SummaryMalfunctioning of the left atrioventricular valve has always been, and remains, the major incremental risk factor in the repair of atrioventricular septal defect. Now that the cardiac surgeon has ample time to assess the anatomy and function of the left valve, results have improved, but are still less than ideal. On the presumption that the anterior leaflet of the mitral valve is “cleft” in this anomaly, it used to be common practice to close the “cleft”. Currently, a substantial number of surgeons employ this technique, often irrespective of the individual anatomy, and in the majority of cases with success.

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