J Korean Pediatr Cardiol Soc.  2005 Dec;9(2):326-333.

Decision of Surgical Treatment Strategy for Hypoplastic Left Ventricle with Coarctation of Aorta

Affiliations
  • 1Department of Thoracic and Cardiovascular Surgery, Yonsei Cardiovascular Hospital, Yonsei University, College of Medicine, Seoul, Korea. yhpark@yumc.yonsei.ac.kr
  • 2Department of Pediatrics, Yonsei Cardiovascular Hospital, Yonsei University, College of Medicine, Seoul, Korea.
  • 3Department of Radiology, Yonsei Cardiovascular Hospital, Yonsei University, College of Medicine, Seoul, Korea.

Abstract

PURPOSE
The purpose of this study is to determine the feasibility of biventricular repair for hypoplastic left ventricle combined with coarctation of aorta and to provide strategy of surgical treatment.
METHODS
The preoperative and postoperative dimension of mitral valve and left ventricle was compared for three patients with hypoplastic left ventricle combined with coarctation of aorta. Ventricular septal defect, atrial septal defect and patent ductus arteriosus were also present in all patients, and the age at the operation was 36, 15 and 11 days. The preoperative end-diastolic left ventricular volume was 13, 28, 24 mL/m2 respectively, and antegrade flow was observed in ascending aorta in all patients.
RESULTS
All patients underwent repair of coarctation of aorta. In addition to coarctation repair, pulmonary arterial banding and atrial septal defect closure was performed in Case 1 and 2 respectively, leaving the ventricular septal defect unclosed. In case 3, the ventricular septal defect was closed with the coarctation repair. Case 1 had to undergo Norwood procedure due to inadequate growth of left ventricle and is waiting for univentricular repair. In Case 2 and 3, the left ventricular size increased and biventricular repair could be performed successfully.
CONCLUSION
Left ventricular growth can be obtained by repair of coarctation and biventricular repair was feasible in selected cases of hypoplastic left ventricle combined with coarctation of aorta. Size and volume measurement of mitral valve and left ventricle with echocardiography or magnetic resonance image provide useful information to decide the surgical strategy for this group of patients.

Keyword

Aortic coarctation; Hypoplasia; Left ventricle

MeSH Terms

Aorta
Aortic Coarctation*
Ductus Arteriosus, Patent
Echocardiography
Heart Septal Defects, Atrial
Heart Septal Defects, Ventricular
Heart Ventricles*
Humans
Mitral Valve
Norwood Procedures
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