The Annals of Thoracic Surgery, Vol 32, 369-376, Copyright © 1981 by The Society of Thoracic Surgeons
Experience with left ventricular apicoaortic conduits for complicated left ventricular outflow obstruction in children and young adults
MA Ergin, R Cooper, M LaCorte, R Golinko and RB Griepp
Six patients, ranging in age from 8 to 20 years, underwent left ventricular
apicoaortic construction for treatment of complicated left ventricular
outflow tract obstruction. All patients had severe left ventricular
hypertrophy as determined by echocardiography and electrocardiography. The
preoperative gradient across the left ventricular outflow tract was 84 +/-
17 mm Hg (mean +/- standard deviation) (range, 65 to 110 mm Hg), and the
preoperative left ventricular end-diastolic pressure was 20 +/- 7 mm Hg
(range, 12 to 28 mm Hg). Conduits were placed retroperitoneally with the
distal anastomosis to the infrarenal aorta; the porcine valve was
positioned in the left upper quadrant. Relief of left ventricular
hypertension was complete; the minimal gradient measured intraoperatively
was 13 +/- 8 mm Hg (range, 0 to 20 mm Hg). With an average follow-up of 18
months (range, 6 to 24 months), all patients have improved and are in
Functional Class I. Four patients were catheterized 12 months
postoperatively. They all showed excellent relief of left ventricular
hypertension; the conduit was effectively decompressing the left ventricle.
This experience suggests that this approach is effective in relieving
complex left ventricular outflow tract obstruction with good early results,
and that it deserves more frequent application in children.
