scholarly journals Outcome of the Repair of Double-Chambered Right Ventricle: A single centre experience

2016 ◽  
Vol 8 (2) ◽  
pp. 165-168
Author(s):  
Mohammad Rokonujjaman ◽  
Md Shaheedul Islam ◽  
Md Sirajul Islam ◽  
Sheikh Mahamoudh ◽  
Md Jasim Uddin ◽  
...  

Background: The presence of anomalous muscle bundles may pro-duce a pressure gradient between the inflow and outflow portions of the right ventricle, resulting in double-chambered right ventricle. We reviewed the outcomes of double chambered right ventricle surgical repair.Methods: Between December 2012 and January 2014, 6 patients under went surgical repair of a double-chambered right ventricle. The patients ranged in age from 3 years to 20 years (mean 8.2±5.9 yrs). Right ventricular outflow tract pressure gradients were from 60 to 120 mm Hg (mean 63.3±40.3). An associated ventricular septal defect was present in 4 patients (66.66%).Results: There were no hospital or late deaths. Mean postsurgical follow up was 3.8±0.8 months). No patient required further surgery to relieve obstruction of right ventricular outflow tract.Conclusions: Surgical repair of a double chambered right ventricle yield excellent hemodynamic and functional results.Cardiovasc. j. 2016; 8(2): 165-168

2008 ◽  
Vol 18 (3) ◽  
pp. 268-274 ◽  
Author(s):  
Ragiab Telagh ◽  
Vladimir Alexi-Meskishvili ◽  
Ronald Hetzer ◽  
Peter E. Lange ◽  
Felix Berger ◽  
...  

AbstractObjectiveBy means of retrospective analysis of our institutional experience, we reviewed the clinical manifestation and outcomes of patients subsequent to surgical repair of double-chambered right ventricle.MethodsBetween 1988 and 2005, we performed surgical repair in 35 of 37 patients diagnosed with double-chambered right ventricle. The patients ranged in age from 4 to 69 years, with a mean of 21.3 years. Most presented in infancy, with initial manifestation of a short systolic murmur in 34 (92%) of all cases. Pressure gradients were measured invasively across the right ventricular outflow tract of between 30 and 140 mmHg, with a median of 60 mmHg. An associated ventricular septal defect was present in 26 patients (70%). Of the group, 4 patients were aged over 40 years, and 2 had previously undergone operative closure of a ventricular septal defect.ResultsThe operative interval ranged from 2 months to 41 years, with a median of 9 years. In all, we resected muscular bundles and enlarged the right ventricular outflow tract. There was no hospital or late death. Median follow-up subsequent to surgery was 7 years, with a range from 0.4 to 11 years. No patient required further surgery to relieve any obstruction of the right ventricular outflow tract, nor long term medical therapy or pacing because of cardiac arrhythmia.ConclusionsSurgical repair of a double-chambered right ventricle yields excellent haemodynamic and functional results over the mid to long term.


2018 ◽  
Vol 7 (2) ◽  
pp. 71-78
Author(s):  
R. M. Sharifulin ◽  
A. V. Bogachev-Prokophiev ◽  
I. I. Demin ◽  
A. B. Open ◽  
M. A. Ovcharov ◽  
...  

Aim The aim of this study was to compare the results of right ventricular outflow tract reconstruction during the Ross procedure with pulmonary allografts versus diepoxide-treated pericardial xenografts. Methods Between 1998 and 2015, 793 adult patients underwent the Ross procedure. The right ventricular outflow tract reconstruction was performed with pulmonary allografts in 185 patients, diepoxide-treated pericardial xenografts in 402 patients. Two groups of patients (122 patients in each group) were allocated using «propensity score matching»: the allograft group (pulmonary allograft) and the xenograft group (xenograft). Surgical results in two groups were assessed. Results The overall early mortality rate in both groups was 2.5%. The mean follow-up was 5,1±2,6 years in the allograft group and 5,2±2,8 years in xenograft group (p = 0,692). The 5-year survival rate did not differ between the study groups (93,7±2,6% in the allograft group versus 94,02±2,4% in the xenograft group, p = 0.748). The peak pressure gradients across the right ventricular outflow tract in early and mid-term follow-up were significantly higher in the xenograft group. Two patients in the xenograft group underwent redo surgeries due to the graft failure. There were no reoperations in the allograft group (p = 0,176). The freedom from right ventricular outflow tract reoperations was 96,3±2,7% for the xenograft group. Conclusion The diepoxide-treated pericardial xenografts demonstrates acceptable haemodynamic results at the mid-term follow-up and could be considered as an alternative to allografts for right ventricular outflow tract reconstruction during the Ross procedure in adults. Further study focused on the assessment of the longterm results are required.


2017 ◽  
Vol 136 (3) ◽  
pp. 262-265 ◽  
Author(s):  
Turgut Karabag ◽  
Caner Arslan ◽  
Turab Yakisan ◽  
Aziz Vatan ◽  
Duygu Sak

ABSTRACT CONTEXT: Obstruction of the right ventricular outflow tract due to metastatic disease is rare. Clinical recognition of cardiac metastatic tumors is rare and continues to present a diagnostic and therapeutic challenge. CASE REPORT: We present the case of a patient who had severe respiratory insufficiency and whose clinical examinations revealed a giant tumor mass extending from the right ventricle to the pulmonary artery. We discuss the diagnostic and therapeutic options. CONCLUSION: In patients presenting with acute right heart failure, right ventricular masses should be kept in mind. Transthoracic echocardiography appears to be the most easily available, noninvasive, cost-effective and useful technique in making the differential diagnosis.


2019 ◽  
Vol 21 (1) ◽  
pp. 65-66
Author(s):  
Sang-Hoon Seol

Double-chambered right ventricle (DCRV) is a cardiac disease of the right ventricular outflow tract obstruction characterized by anomalous muscle bundles that divide the right ventricle into two chambers. It may be also develop over time as an acquired lesion in patients with an abnormally short distance between the moderator band and the pulmonary valve. This report highlights the case of a man with double-chambered right ventricle after ventricular septal defect operation, who presented with syncope J MEDICINE JAN 2020; 21 (1) : 65-66


2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Bortolo Martini ◽  
Nicola Trevisi ◽  
Nicolò Martini ◽  
Li Zhang

A 43-year-old woman presented to the emergency room with a sustained ventricular tachycardia (VT). ECG showed a QRS in left bundle branch block morphology with inferior axis. Echocardiography, ventricular angiography, and cardiac magnetic resonance imaging (CMRI) revealed a normal right ventricle and a left ventricular diverticulum. Electrophysiology studies with epicardial voltage mapping identified a large fibrotic area in the inferolateral layer of the right ventricular wall and a small area of fibrotic tissue at the anterior right ventricular outflow tract. VT ablation was successfully performed with combined epicardial and endocardial approaches.


2021 ◽  
Vol 9 ◽  
Author(s):  
Wangping Chen ◽  
Chukwuemeka Daniel Iroegbu ◽  
Xia Xie ◽  
Wenwu Zhou ◽  
Ming Wu ◽  
...  

Introduction: The purpose of this study was to report our experience in the surgical reconstruction of the right ventricular outflow tract in double outlet right ventricle with a major coronary artery crossing the right ventricular outflow tract in the presence of mirror image-dextrocardia.Methods: From January 2005 to December 2019, 19 double outlet right ventricle patients (median age 4 years) with mirror image-dextrocardia and a major coronary artery crossing the right ventricular outflow tract received surgical repair. An autologous pericardial patch was used to enlarge the right ventricular outflow tract in four patients without pulmonary stenosis and three patients with mild pulmonary stenosis. A valved bovine jugular venous conduit was added to a hypoplastic native pathway in nine patients, among which six patients with moderate pulmonary stenosis received small-sized bovine jugular venous conduit implantation (diameter ≤ 16 mm). In comparison, a large-sized bovine jugular venous conduit (diameter >16 mm) was adopted in a total of three patients with severe pulmonary stenosis. Finally, three patients with preoperative pulmonary hypertension (mean pulmonary artery pressure ≥40 mmHg) did not undergo further intervention of right ventricular outflow tract due to the adequate outflow tract blood flow.Results: There was no hospital mortality. One patient with sub-pulmonary ventricular septal defect and concomitant severe pulmonary hypertension died from respiratory failure 11 months after the operation. Kaplan-Meier survival was 94% at 5, 10 years. Within a mean echocardiographic follow-up of 6.9 ± 3.6 years, a total of two patients received reintervention due to valvular stenosis of the bovine jugular venous conduit (pressure gradient > 50 mmHg at 4 and 9 years) after surgical operation. Actuarial freedom from reoperation was 90 and 72% at 5 and 10 years, respectively. During the last echocardiographic follow-up phase, all the survivors were in NYHA class I.Conclusions: Double outlet right ventricle with mirror image-dextrocardia is a rare and complicated congenital cardiac malformation. Surgical reconstruction of the right ventricular outflow tract should be individualized based on the degree of pulmonary stenosis and the specific anatomical features of each patient. Reconstructing the pulmonary artery using the various sizes of valved bovine jugular venous conduit is a safe and effective surgical method.


2016 ◽  
Vol 43 (4) ◽  
pp. 357-359 ◽  
Author(s):  
Walid K. Abu Saleh ◽  
Chun Huie Lin ◽  
Michael J. Reardon ◽  
Basel Ramlawi

Isolated sinus of Valsalva aneurysm is a rare occurrence, with an incidence of <1.5% among congenital heart disease repairs in the world. We recount the case of a 64-year-old man who presented with right-sided heart failure symptoms caused by a severely dilated right coronary sinus of Valsalva aneurysm that substantially obstructed the right ventricular outflow tract. Successful surgical repair involved right ventricular outflow tract resection and subcoronary patch repair.


2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Wojtkowska ◽  
R Zarczuk ◽  
W Brzozowski ◽  
S Lukasik ◽  
M Tomaszewski ◽  
...  

Abstract Hypertrophy of the right ventricle (RV) in the course of hypertrophic cardiomyopathy (HCM) is found in 30-60% of cases, with the possibility of a right ventricular outflow tract obstruction (RVOTO), obstruction in the apex or the middle part of the right ventricle. A patient, aged 41, admitted due to limitation of exercise tolerance, effort dyspnea, presyncope. In an echocardiogram, interventricular septum (IVS) hypertrophy was observed up to 2.0 cm; normal size of the heart cavities; normal left ventricular systolic function (EF-70%). A color doppler mapping detected the zone of flow acceleraction and turbulent flow in right ventricular outflow tract (RVOT), next a spectral doppler examination showed the RVOT obstruction with a maximal gradient of 64 mmHg. Because of the suboptimal echocardiographic imaging, a heart CT scan was performed, revealing the features of left ventricular hypertrophy, most severe at the base and the medium part of IVS (up to 25 mm). Asymmetric hypertrophy of the middle portion of the right ventricle and right ventricular outflow tract obstruction was also observed. A hemodynamic study confirmed the presence of gradient in RVOT, up to 40 mmHg. Holter electrocardiogram recorded an episode of non-sustained ventricular tachycardia. Taking into account the clinical picture, the family history of the disease, and calculated HCM Risk SCD (7.55%), the decision was made to implant a dual chamber cardioverter defibrillator. The defibrillator electrode was fixed at the apex of the right ventricle. A short AV delay was programmed for prevalent right ventricular stimulation (AV delay 100 ms), resulting in 99.6% ventricular stimulation. The control echocardiogram showed a reduction in the maximum gradient in RVOT to 24 mmHg. In addition, the patient was treated with a beta-blocker. To sum up, in the case of HCM we should always examine the RV with color and spectral doppler to exclude potential narrowing in RV. Constant AV sequential stimulation with a short AV delay is a recognized method that can be considered in symptomatic adult HCM patients with a left ventricular outflow tract obstruction. In the case described here, the above mentioned method proved effective in the significant reduction of the gradient in the right ventricular outflow tract. Abstract 113 Figure. gradient in RVOT


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