title: Apico-aortic conduits in children with severe left ventricular outflow tract obstruction.
abstract: BACKGROUND
  Infrequently, congenital heart defects are complicated by left ventricular outflow tract obstruction (LVOTO) not amenable to conventional reconstruction. Apico-aortic conduits provide a means of palliating such patients until definitive repair is possible. The purpose of this study was to review a single institution's current experience with apico-aortic conduits.
  
  
  METHODS
  The medical records of pediatric patients receiving apico-aortic conduits were reviewed. Demographics, operative techniques, preoperative and postoperative physiologic variables, morbidity, mortality, and functional class were recorded. Off-pump and on-pump procedures were categorized for comparison.
  
  
  RESULTS
  Ten cases of apico-aortic conduits for left ventricular outflow tract obstruction were identified. Indications included congenital aortic stenosis, aortic atresia, and subaortic stenosis. Six procedures were performed off-pump and four required median sternotomy with cardiopulmonary bypass as necessitated by concomitant procedures. There was one operative death. The remaining patients demonstrated hemodynamic improvements and are all alive to date. One patient required conduit valve replacement. All patients are in New York Heart Association classification I or II at the time of last follow-up.
  
  
  CONCLUSIONS
  Apico-aortic conduits provide a safe and effective treatment alternative for select cases of left ventricular outflow tract obstruction. Off-pump techniques are feasible in the majority of cases. This valuable adjunct should be considered whenever conventional repair of left ventricular outflow tract obstruction is considered prohibitive.
authors.affiliation: Division of Cardiothoracic Surgery, Medical College of Georgia, Augusta 30912, USA.
authors.forename: Sohit K
authors.initials: SK
authors.lastname: Khanna
authors.forename: Mark P
authors.initials: MP
authors.lastname: Anstadt
authors.forename: Shabir
authors.initials: S
authors.lastname: Bhimji
authors.forename: Mary M
authors.initials: MM
authors.lastname: Bannan
authors.forename: Kwabena
authors.initials: K
authors.lastname: Mawulawde
authors.forename: G Lionel
authors.initials: GL
authors.lastname: Zumbro
authors.forename: H Victor
authors.initials: HV
authors.lastname: Moore
mesh_terms: D019917:Blood Vessel Prosthesis Implantation; D002315:Cardiopulmonary Bypass; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D014694:Ventricular Outflow Obstruction / Q000150:complications / Q000601:surgery*