Surgical Management of Subaortic Obstruction in Single Left Ventricle and Tricuspid Atresia

摘要: Subaortic obstruction caused by either a restrictive bulboventricular foramen in single left ventricle with an outflow chamber or ventricular septal defect tricuspid atresia transposition of the great arteries can lead to hypertrophied, noncompliant and excessive pulmonary blood flow. This combination is disadvantageous potential Fontan procedure candidates because they are dependent on good function low vascular resistance for survival. The results surgical procedures directly indirectly relieve significant subaortic (gradient 30 mm Hg) 24 patients, 16 8 atresia, were reviewed. Four patients had apex descending aorta valved conduit; none survived. Seven resection tissue; four survived developed heart block at surgery. Adequate gradient relief was evident only one survivors. Thirteen main artery ascending anastomosis six AH survivors adequate relief. overall survival 42% (10 24). None seven >75 Hg These data show that: 1) Surgical established carries high mortality rate, especially if Hg. 2) best appears be anastomosis. 3) A clearer understanding factors leading development necessary prevent it devise improved therapeutic strategies.