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Anatomic Repair for Corrected Transposition With Left Ventricular Outflow Tract Obstruction  Takaya Hoashi, MD, PhD, Koji Kagisaki, MD, Aya Miyazaki,

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Presentation on theme: "Anatomic Repair for Corrected Transposition With Left Ventricular Outflow Tract Obstruction  Takaya Hoashi, MD, PhD, Koji Kagisaki, MD, Aya Miyazaki,"— Presentation transcript:

1 Anatomic Repair for Corrected Transposition With Left Ventricular Outflow Tract Obstruction 
Takaya Hoashi, MD, PhD, Koji Kagisaki, MD, Aya Miyazaki, MD, Kenichi Kurosaki, MD, Isao Shiraishi, MD, PhD, Toshikatsu Yagihara, MD, Hajime Ichikawa, MD, PhD  The Annals of Thoracic Surgery  Volume 96, Issue 2, Pages (August 2013) DOI: /j.athoracsur Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Flow chart of surgically treated patients with congenitally corrected transportation of great arteries (ccTGA) with left ventricular outflow tract obstruction (LVOTO) and ventricular septal defect (VSD). (CDH = congenital diaphragm hernia; DORV = double outlet right ventricle.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Size of ventricular septal defect (VSD, ■) area and left ventricular outflow tract (LVOT, □) area in patients undergoing additional Damus-Kaye-Stansel anastomosis (n = 9). Both VSD area and LVOT area were expressed as % of normal aortic valve (AV) area. Patients 1 and 2 concomitantly underwent VSD enlargement. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 (A) Overall survival rate estimated by the Kaplan-Meyer method. (B) No mortality has been observed in 21 consecutive patients since 1997 (Log-rank: p = 0.006). The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 Freedom from (A) reoperation rate, (B) pacemaker implantation (PMI) rate, and (C) reoperation for right ventricular outflow tract (RVOT) rate estimated by the Kaplan-Meyer method. (D) No reoperation cases have been observed in 14 consecutive patients that underwent our tailor-made RVOT reconstruction (log-rank: p = 0.18). (RVOTR = right ventricular outflow tract reconstruction). The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

6 Fig 5 (A) Freedom from reintervention for caval obstruction rate estimated by the Kaplan-Meyer method. (B) No patient undergoing Senning developed caval obstruction. (C) Coexisted apicocaval juxtaposition (ACJ), or (D) double-sided superior vena cavae (SVC) was not a risk factor. (bSVC = both sided superior vena cavae). The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

7 Fig 6 (A) Changes of right ventricular end-diastolic volume (RVEDV) before and 1 year after the operation. (B) Correlation between RVEDV and postoperative right ventricular end-diastolic pressure (RVEDP) or (C) the cardiac index (CI) 1 year after the operation. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions


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