Abstract 2637: Long-term Results of Ventricular Septation of the Single Left Ventricle
Background: Ventricular septation is an option for surgical correction of double inlet left ventricle (LV) and it provides an alternative to the Fontan operation. However, long-term results of the ventricular septation remain unclear.
Objective: To evaluate long-term outcome and quality of life of the patients after the ventricular septation.
Methods: From 1971 to 2000, 33 patients with single LV underwent the ventricular septation. 9 patients (27%) underwent pace-maker implantation for complete AV block at the time of the septaion. The median age at operation was 7 years old, ranging 0.2 to 24 years. There were 5 hospital deaths (15%) and the remaining 28 patients were the subjects of this study. The charts of these patients were reviwed retropspectively. The median follow-up period was 12 years (range 0.3 to 35 years).
Results: The age of patients at the time of this survay was 20+/-9 years, ranging 2– 44 years. There were 6 late deaths, 7+/-7 (range 0.3–18 years) after the operation; sudden death in 2 patients and death due to chronic heart failure in 4 patients. The actuarial survival was 86% at 10 years, 78% at 15 years, 70% at 20 years. Before operation, angiography showed LV end-diastolic volume of 230% of normal and LV ejection fraction of 55%. Angiography 7 +/-7 years after the operation showed LV end-diastolic volume of 144% of normal (range 91 to 205%) and LV ejection fraction of 48% (range 30 to 61%). Of 22 survivors, 20 (91%) were in NYHA functional class I, one in class II, and one in class III. 7 patients were students. All other patients except one had full-time job and only one patient was unemlployed. 47% of survivors had anti-heart failure medication such as diuretics and/or angiotension-converting enzyme inhibitors. 40% of patients had anti-coagulants (aspirin and/or coumadin). Significant atrial and ventricular tachyarrhythmia was noted in 1 patient, respectively. One patient had late pacemaker implantation 6 years after the operation.
Conclusion: Long-term results and quality of life of most patients who survived the operation are good. Although mild heart failure exists in some patients, late development of significant arrhythmia is rare after the ventricular septation.