Why the study?
In patients with double outlet right ventricle, a non-committed ventricular septal defect, and abnormal tricuspid valve tension apparatus insertion, extensive enlargement of the defect is required to create the interventricular rerouting needed for an arterial switch operation.
Case Report (n=1)
No
Demonstrates successful arterial switch repair after extensive ventricular septal defect enlargement in double outlet right ventricle, indicating feasibility of biventricular reconstruction.
We performed an arterial switch operation in a patient with double outlet right ventricle with non-committed ventricular septal defect, and abnormal insertion of the tension apparatus of the tricuspid valve which produced moderate tricuspid regurgitation. This required extensive enlargement of the ventricular septal defect between the attachments of the cords of the tricuspid valve so as to create the interventricular rerouting that made possible the arterial switch operation. Postoperatively, we produced a straight, unobstructed, left ventricular outflow tract, improved the extent of tricuspid regurgitation, and achieved low right atrial pressures. Enlargement of the interventricular communication can set the scene for biventricular repair in this particular subset of patients with both arterial trunks arising from the morphologically right ventricle.
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Ishibashi et al. (2005) conducted a case report in Double-outlet right ventricle with a remote non-committed ventricular septal defect and severe pulmonary valvular stenosis (n=1). Creation of a new interventricular communication in the subpulmonary outflow tract with intraventricular baffle and 16-mm Contegra conduit placement was evaluated on Unobstructed left ventricular outflow to the aorta and proportion of left ventricular flow through the newly created interventricular communication at 2 months.
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