| From your Guide Dr.MANI |  | |
Double Outlet Right Ventricle | ||
| From your Guide Dr.MANI | | |
Double Outlet Right Ventricle | ||
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What is the best age to repair DORV ?
Since DORV is not a single entity, the best age for repair depends on the type of DORV. When
there is no pulmonary stenosis, DORV with subaortic or subpulmonary VSD can be repaired
electively at 6 months of age. For DORV with non-committed VSD, later repair at 3 to 5 years age
is advisable.
When pulmonary stenosis is present, DORV with subaortic VSD is treated exactly as Tetralogy of
Fallot. DORV with subpulmonary or non-committed VSD is electively repaired at 3 to 5 years age.
However, none of these suggestions are absolute ones. Decision making in individual cases
depends on the specific nature of each patient.
What is the outcome after DORV repair ?
These are still uncharted waters. Most published operation series have a mixture of all the subtypes
of DORV. In a complex and variable condition like this, such reports on a non-homogenous group
are not predictive.
For instance, the outcome of DORV with subaortic VSD, good ventricular function and no
pulmonary stenosis will differ considerably from DORV with subpulmonic VSD, small left ventricle
and pulmonary stenosis. Much more analysis, particularly after categorizing cases according to their
anatomy, is needed.
In general, there is a 5% risk of operative mortality, and about 80% of patients are alive 5 years
after surgery.
Late complications are uncommon if the operation has been properly designed and executed.
Rarely, rhythm disturbances - arrhythmias - have caused sudden death, but the risk of this varies in
different reports. Complications are more common in the non-committed VSD group, since usually
more complex repair techniques are needed in these patients.
If there's anything more you want to read about, or some areas which aren't clear enough, don't
hesitate to write and let me know.
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Copyright 1998, All rights reserved. |
