Long-term prognosis after repair of double-chamber right ventricle with ventricular septal defect.
To determine long-term postoperative results in patients with double-chamber right ventricle and ventricular septal defect, 20 patients who had survived complete repair between 1959 and 1966 were recalled and studied. An interview, physical examination, electrocardiogram and chest x-ray were performed in all 20 patients, a treadmill exercise test in 16, 24-hour Holter monitor recording in 7 and postoperative cardiac catheterization in 8. Mean age at repair was 14 years and at follow-up evaluation 33 years. There were no late deaths. At a mean follow-up of 19 years, 17 patients were in New York Heart Association functional class I, 1 patient was in class II and 2 patients were in class III. Reoperation was performed in 2 patients (10%), and at present only 1 patient (5%) is considered to have hemodynamically significant cardiac compromise. Aortic regurgitation, not present in any patient preoperatively, developed in 5 patients (25%). Mild residual right ventricular outflow obstruction was present in 2 (10%) and the murmur of a hemodynamically insignificant residual ventricular septal defect or tricuspid regurgitation was present in 5 patients (25%). One patient (5%) had cardiomegaly (cardiothoracic ratio greater than 0.55). The frequency of infective endocarditis in the postoperative follow-up period was 1 per 388 patient-years. Thus, 20 years after repair of double-chamber right ventricle, mild residua and sequelae are common, but serious cardiac compromise is infrequent.
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000175:diagnosis / Q000209:etiology; D006345:Heart Septal Defects, Ventricular / Q000601:surgery*; D006349:Heart Valve Diseases / Q000175:diagnosis; D006352:Heart Ventricles / Q000002:abnormalities* / Q000601:surgery; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D011379:Prognosis; D012086:Reoperation; D013997:Time Factors