DOUBLE-CHAMBERED RIGHT VENTRICLE

Between May 1974 and December 1993, 37 patients (0.75%) with a double- chamber right ventricle underwent surgical repair. The patients ranged in age from 11 months to 12 years (mean 4 +/- 1.1 years). Cardiac cat heterization was performed in 36 patients. The proximal right chamber pressure was 118 +/- 10 mmHg and the mean ventricular gradient pressur e was 75 +/- 10 mmHg. A ventricular septal defect was present in 36 ca ses and fixed subaortic stenosis in eight. Longitudinal right ventricu lotomy, group I, was performed in 19 patients (51.3%): 11 had a perime mbranous ventricular septal defect and eight and infundibular ventricu lar septal defect. Combined pulmonary arteriotomy and right atriomony, group II, was performed in 18 patients (48.7%): 17 patients had a per imembranous ventricular septal defect. The ventricular septal defect w as closed using a double velour patch in 26 patients, continuous sutur e in fur and a Gore-Tex patch in six. In the ventriculotomy group one patient died shortly after the operation (following pulmonary complica tion), and ten patients required inotropic support. Two patients devel oped patch dehiscence and underwent reoperation. There were no complic ations in group II patients who underwent right atriotomy. Associated cardiac anomalies were corrected in all patients. Follow-up of 6.5 +/- 3.1 years after operation showed that 36 patients were alive and asym ptomatic. Conclusion: the transatrial approach with pulmonary arteriot omy is an appropriate and effective double-chambered right ventricle c orrection even if it is associated with a perimembranous ventricular s eptal defect.