Long-Term Results for Atrioventricular Connection in Tricuspid Atresia
From July 1977 to July 1984, 28 patients aged 3–37 years (mean 9.6 ± 7.0) with tricuspid atresia underwent atrioventricular connection. The surgical procedure was the same for all patients: transverse incision of the pulmonary outflow tract which permits conservation of the pulmonary valve and annulus in its anatomic position; the inferior portion of the infundibular incision was used to exclude the ventricular septal defect. The atrioventricular connection was made with a Dacron conduit (15 patients) or an anterior gusset with direct posterior suture (13 patients).
Hospital mortality (1st month) was 14.3% (4/28). Late mortality was 8.3% (2 + and 3 + months: heart failure). Cumulative follow-up was 132 patient/years. Two patients underwent reoperation for obstructed conduit. At 6 years, 78.5% ± 15.4% of the patients were still alive.
Long-term follow-up data were based upon clinical status, ECG and Holter monitoring, echocardiography, exercise testing, and liver function evaluation. At last follow-up, 70% were in class I (NYHA), 25% in class II, and one patient in class III. All patients were in sinus rhythm at rest, but 5% experienced arrhythmia at exercise. Echocardiographic evaluation of the right atrium showed normal size and good contractility in 56% of the cases, and in the remaining patients, in spite of right atrium dilation, contractility was preserved. We conclude that this type of atrioventricular connection is one of the best options for tricuspid atresia offering good long-term results.
KeywordsVentricular Septal Defect Holter Monitoring Tricuspid Atresia Versus Connection Ventricular Septal Defect Closure
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- 2.Fontan F, Choussat A, Brom AG et al. (1977) Repair of tricuspid atresia. Surgical considerations and results. In: Anderson RH, Shinebourne EA (eds) Pediatric cardiology 1977. Churchill Livingstone, London, pp 567–580Google Scholar
- 4.Mair D, Rice M, Hagler D, Puga F, McGoon D, Danielson G (1985) Outcome of the Fon-tan procedure in patients with tricuspid atresia. Circulation 72[Suppl II]:II, pp 88–92Google Scholar