Ventricular hypertrophy as a risk factor in ventricular septation for double-inlet left ventricle.
BACKGROUND
Ventricular septation is an option for surgical correlation of double-inlet or common-inlet left ventricle. However, the surgical risk factors of ventricular septation remain unknown.


METHODS
Twenty-three patients with double-inlet or common-inlet left ventricle underwent ventricular septation. Preoperative data were compared between the survivors (n = 18) and the nonsurvivors (n = 5) to assess surgical risk factors.


RESULTS
There were two early deaths (9.5%) and three late deaths (14.3%). Nonsurvivors of ventricular septation were significantly older at the time of operation (14.0 +/- 6.0 versus 7.0 +/- 5.4 years; p < 0.05) and had greater left ventricular mass (383% +/- 100% versus 206% +/- 57% of normal predicted value; p < 0.005) and greater left ventricular mass to left ventricular end-diastolic volume ratio (1.84% +/- 1.18% versus 0.77% +/- 0.17%/% of normal predicted value; p < 0.005). Univariate logistic regression analysis also revealed age at operation (p < 0.05) and mass/end-diastolic volume ratio (p < 0.05) as significant risk factors for death after operation. Multivariate regression analysis revealed that age at operation positively influenced increased mass/end-diastolic volume ratio (p < 0.001). These findings indicated that ventricular hypertrophy was one of the risk factors for ventricular septation, which had a tendency to progress with age.


CONCLUSIONS
Early operation before progression of ventricular hypertrophy is recommended in patients with double-inlet or common-inlet left ventricle who have suitable anatomy for the ventricular septation procedure.
Nagashima
M
M
Department of Pediatric Cardiovascular Surgery, Tokyo Women's Medical College, Japan.
Imai
Y
Y
Takanashi
Y
Y
Hoshino
S
S
Seo
K
K
Terada
M
M
Aoki
M
M
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002306:Cardiac Volume; D002648:Child; D002675:Child, Preschool; D005260:Female; D005544:Forecasting; D006330:Heart Defects, Congenital / Q000601:surgery*; D006352:Heart Ventricles / Q000002:abnormalities / Q000601:surgery; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000209:etiology*; D007223:Infant; D016015:Logistic Models; D008297:Male; D010100:Oxygen / Q000097:blood; D010496:Pericardium; D011093:Polyethylene Terephthalates; D011183:Postoperative Complications; D019736:Prostheses and Implants; D011666:Pulmonary Valve Stenosis / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D013318:Stroke Volume; D014655:Vascular Resistance; D016277:Ventricular Function, Left; D017725:Ventricular Pressure
D011093:Polyethylene Terephthalates; D010100:Oxygen