Department of Cardiovascular Surgery, Chiba Children's Hospital, 579-1 Heta, Midori, Chiba-City, 266-0007, Japan.
Gen Thorac Cardiovasc Surg. 2023 Jul;71(7):391-395. doi: 10.1007/s11748-022-01897-1. Epub 2023 Jan 3.
The one-and-a-half ventricle repair (1.5VR) is an option for definitive surgery of cardiac defects with hypoplastic right ventricle (RV). The 1.5VR with open azygos vein was reported to provide a theoretical advantage of decompressing the supra vena cava (SVC) or the right atrium in patients with SVC hypertension or severe RV dysfunction. The aim of this study is to review and evaluate our experience with this procedure in the long-term period.
Medical records of the patient undergoing 1.5VR with open azygos vein between January 2000 and December 2019 were reviewed retrospective. Pre- and postoperative echocardiography and cardiac catheterization data were also analyzed.
4 patients underwent the 1.5VR with open azygos vein. The median age at time of surgery was 2.2 years, and the median weight was 9.8 kg. The median tricuspid valve (TV) Z-score was - 3.5, the median right ventricular end-diastolic volume (RVEDV) was 54.0% of normal. There were no operative death and early adverse events. Median follow-up time was 17.1 years. There were no late death and re-operation during the follow-up. The postoperative TV diameter and RVEDV were larger than preoperative data in 3 of 4 patients.
The 1.5VR with open azygos vein is a good surgical option for congenital heart disease with hypoplastic RV. The TV and RVEDV may grow and biventricular conversion may be possible.
对于右心室发育不良（RV）的心脏缺陷，一到半心室修复术（1.5VR）是一种可行的根治性手术方法。有报道称，1.5VR 联合开放奇静脉可提供理论上的优势，即减轻上腔静脉（SVC）或右心房在 SVC 高压或严重 RV 功能障碍患者中的压力。本研究旨在回顾和评估我们在长期应用该术式的经验。
回顾性分析 2000 年 1 月至 2019 年 12 月期间接受 1.5VR 联合开放奇静脉手术的患者的病历。同时还分析了术前和术后的超声心动图和心导管检查数据。
4 例患者接受了 1.5VR 联合开放奇静脉手术。手术时的中位年龄为 2.2 岁，中位体重为 9.8kg。三尖瓣（TV）Z 评分中位数为-3.5，右心室舒张末期容积（RVEDV）中位数为正常的 54.0%。无手术死亡和早期不良事件。中位随访时间为 17.1 年。随访期间无晚期死亡和再次手术。4 例患者中有 3 例术后 TV 直径和 RVEDV 大于术前数据。
1.5VR 联合开放奇静脉是治疗 RV 发育不良先天性心脏病的良好手术选择。TV 和 RVEDV 可能会增大，双心室转换可能成为可能。
