Anatomic repair of anomalies of ventriculo-arterial connection (REV). Results of a new technique in cases associated with XXXX .

@entity1 @entity154 @entity1757 @entity3885 @entity849
From November 1980 to November 1986, 63 @entity1 aged 4 months to 13 years (mean 3.4 years) underwent repair of anomalies of ventriculo-arterial connection with @entity1757 and @entity3885 , using a technique (REV) first described by us in 1982. The selection of @entity1 was based on preoperative criteria, namely the measurement of the distance between the tricuspid and the semilunar valves. These measurements enabled us to select from @entity1 with an abnormal ventriculo-arterial connection, those in whom the @entity154 could be repaired by intra-ventricular partition alone. In the remaining cases, REV was indicated in the presence of @entity849 . The principles of the technique are: (1) resection of the infundibular septum creating a large, direct and subarterial communication between the left ventricle and the aorta; (2) construction of a straight left ventricle to aorta tunnel by intraventricular partition; (3) direct anastomosis of the pulmonary trunk to the right ventricle. There were 12 hospital deaths (19%). The mean follow-up was 32 months. One @entity1 died suddenly 1 year after repair. Six @entity1 required reoperation. All survivors are in NYHA class I, except for 3 @entity1 who are in class II. No stenosis of the left ventricular outflow tract was found but 5 @entity1 had a significant pressure gradient at the pulmonary outflow tract level. Our present experience suggests that in properly selected @entity1 , REV allows anatomic repair in a wide variety of anomalies of the ventriculo-arterial connection associated with @entity1757 and @entity3885 with an acceptable rate of mortality and morbidity.
