Surgical palliation in patients with a single ventricle and dextrocardia.

摘要: Background Dextrocardia is found in a significant proportion of patients undergoing single-ventricle repair. Surgical outcomes this cohort are unclear. Methods The records 41 consecutive with physiology and dextrocardia presenting single institution from 1990 to 2008 were reviewed. Of cohort, 19 had heterotaxy syndrome. Twenty-five the atrioventricular valve regurgitation (AVVR) on presentation (mild, 13; moderate, 9; severe, 3). Results One patient died before intervention. Initial surgical palliation was performed 31 patients. Four postoperatively 4 interim deaths occurred between initial bidirectional cavopulmonary shunt (BCPS). Thirty surviving 32 underwent BCPS, 2 perioperative deaths. There additional Fontan surgery. Twenty-two 25 procedure. 1 postoperative mortality. Survival age 15 years 56% (95% confidence interval [CI], 39%-70%). Patients moderate or severe higher mortality if they managed conservatively rather than by surgery (5 6 vs 6; P  = .24). bilateral BCPS better operative survival compared peers unilateral anastomosis (odds ratio, 27;  = .005; 95% CI, 2.7-269). side systemic venous pathway did not seem influence outcomes. Conclusions poor dextrocardia. Aggressive management congenital AVVR might improve long-term prognosis.