VENTRICULAR HYPERTROPHY AS A RISK FACTOR IN VENTRICULAR SEPTATION FORDOUBLE-INLET LEFT-VENTRICLE

Background. Ventricular septation is an option for surgical correction 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 under went ventricular septation. Preoperative data were compared between th e survivors (n = 18) and the nonsurvivors (n = 5) to assess surgical r isk factors. Results. There were two early deaths (9.5%) and three lat e deaths (14.3%). Nonsurvivors of ventricular septation were significa ntly older at the time of operation (14.0 +/- 6.0 versus 7.0 +/- 5.4 y ears; 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% +/- 017%% of normal predicted value; p < 0.005). Univariate logistic regression analysis also revealed age at o peration (p < 0.05) and mass/end-diastolic volume ratio (p < 0.05) as significant risk factors for death after operation. Multivariate regre ssion analysis revealed that age at operation positively influenced in creased mass/end-diastolic volume ratio (p < 0.001). These findings in dicated that ventricular hypertrophy was one of the risk factors for v entricular septation, which had a tendency to progress with age. Concl usions. Early operation before progression of ventricular hypertrophy is recommended in patients with double-inlet oh common-inlet left vent ricle who have suitable anatomy for the ventricular septation procedur e. (C) 1997 by The Society of Thoracic Surgeons.