• J. Thorac. Cardiovasc. Surg. · Sep 2014

    Twenty-five years' experience of modified Lecompte procedure for the anomalies of ventriculoarterial connection with ventricular septal defect and pulmonary stenosis.

    • Hong-Gook Lim, Woong-Han Kim, Jeong Ryul Lee, and Yong Jin Kim.
    • Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Republic of Korea.
    • J. Thorac. Cardiovasc. Surg.. 2014 Sep 1;148(3):825-31.

    ObjectivesTo overcome the drawbacks of the Rastelli operation, the modified Lecompte procedure creates a connection from the left ventricle to the aorta with greater freedom from residual obstruction due to the resection of the outlet septum and avoids the implantation of an extracardiac valved conduit. We evaluated the effectiveness of this technique with analysis of our 25-year long-term results.MethodsWe reviewed the records of 50 patients who underwent the modified Lecompte procedure during the past 25 years. The median age at operation was 1.95 years (range, 0.30-12.48 years). The diagnoses involved anomalies of the ventriculoarterial connection with ventricular septal defect and pulmonary outflow tract obstruction, such as transposition of the great arteries, double outlet right ventricle, and double outlet left ventricle.ResultsThere were 2 early deaths (4.0%). During a mean follow-up of 14.2 ± 7.9 years (range, 0.2-25 years), there were 4 late deaths. Actuarial survival was 87.3% ± 4.9% at 25 years. The freedom from arrhythmia and reoperation at 25 years was 87.7% ± 6.2% and 25.2% ± 9.4%, respectively. The freedom from reoperation for left ventricular outflow tract obstruction and right ventricular outflow tract obstruction at 25 years was 88.5% ± 5.4% and 49.6% ± 9.0%, respectively. At last follow-up, 43 survivors (97.7%) are in New York Heart Association class I.ConclusionsThe modified Lecompte procedure has excellent long-term results for treating anomalies of ventriculoarterial connection with ventricular septal defect and pulmonary outflow tract obstruction. Early repair is possible with low mortality and morbidity in terms of arrhythmia, reoperation for right or left ventricular outflow tract obstruction, and functional class.Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

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