Techniques and results in the management of XXXX .

@entity1 @entity215 @entity120 @entity1757 @entity616 @entity849 @entity1498 @entity1147 @entity472 @entity121 @entity1002
OBJECTIVE: The management of @entity1 with @entity1757 remains controversial. Primary closure, interventional catheter techniques, and palliative surgery all may have a role, and specific management guidelines remain undefined. METHODS: We reviewed the records of all 33 @entity1 with @entity1757 undergoing repair between January 1988 and October 1996. @entity120 was present in 21 @entity1 (group 1), and @entity849 was present in the remaining 12 (group 2). Closure was accomplished from a right atriotomy alone in most @entity1 , although an apical left ventriculotomy was used for apical defects. Among group 1 @entity1 , the mean age at repair was 5.9 +/- 0.9 months. Major associated anomalies included @entity1498 (n = 6), straddling tricuspid valve (n = 1), and critical @entity472 (n = 1). Reoperation was performed in two @entity1 for residual @entity1757 . Among group 2 @entity1 , the mean age at repair was 6.6 +/- 3.2 years. Major associated anomalies included @entity215 (n = 2), @entity849 (n = 4), @entity1147 right ventricle with hypoplastic left ventricle (n = 1), and isolated @entity1002 (n = 1). Three required reoperation for residual @entity1757 . RESULTS: There were no early or late deaths, no episodes of @entity616 , and no significant residual @entity1757 among group 1 @entity1 . All group 1 @entity1 remain free of significant residual cardiovascular conditions at a mean of 23.4 +/- 5.1 months. Among group 2 @entity1 , there was one early death in a @entity1 with @entity1147 right ventricle and @entity1002 . Complete @entity616 occurred in two @entity1 and one required late mitral valve replacement. There were no late deaths, seven remain alive without significant residual defects at a mean of 36.2 +/- 8.0 months, and two required transplantation for @entity1002 . CONCLUSIONS: Primary repair for @entity1 with @entity1757 is associated with good late outcomes. The right atrial approach is satisfactory for most @entity121 , although limited apical left ventriculotomy was used for apical defects. Pulmonary artery banding should be limited to @entity1 with complex associated defects.
