Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-10T07:55:37.318Z Has data issue: false hasContentIssue false

Surgical correction of a patient with discordant atrioventricular and concordant ventriculo-arterial connections

Published online by Cambridge University Press:  19 August 2008

Kiyozo Morita
Affiliation:
Jikei University School of Medicine, Department of Cardiovascular Surgery, Tokyo, Japan
Hiromi Kurosawa*
Affiliation:
Jikei University School of Medicine, Department of Cardiovascular Surgery, Tokyo, Japan
Hisaki Miyamoto
Affiliation:
Jikei University School of Medicine, Department of Cardiovascular Surgery, Tokyo, Japan
*
Hiromi Kurosawa, M.D. Department of Cardiac Surgery, Jikei Univ. School of Medicine, 3-19-18 Nishi-shinbashi, Minato-ku, Tokyo, 105, Japan. Tel 3-3433-1111; Fax: 3-3943-7515

Abstract

The combination of discordant atrioventricular and concordant ventriculoarterial connections is an extremely rare entity, with only 8 cases of successful surgical repair being previously reported. Although from the clinical standpoint this anomaly is similar to complete transposition, this unusual combination is clearly suited by its morpho-physiological features to an atrial rather than an arterial switch procedure. A 17-year-old boy with this malformation, associated also with severe pulmonary hypertension, underwent a palliative Senning procedure, leaving the ventricular septal defect open and banding the pulmonary trunk. Postoperatively, hypoxemia was markedly improved, and was associated with a reduction of the level of pulmonary hypertension, contributing to marked symptomatic improvement.

Type
Brief-Reports
Copyright
Copyright © Cambridge University Press 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Van, Praagh R, Van, Praagh S. Isolated ventricular inversion: a consideration of the morphogenesis, definition and diagnosis of nontransposed and transposed great arteries.Am J Cardiology 1966;17:395406Google Scholar
2.Espino-Vela, J, de, la Cruz MV, Munoz-Castellanos, L, Plaza, L, Attie, F. Ventricular inversion without transposition of the great vessels in situs inversus. British Heart Journal 1970; 32: 292303.CrossRefGoogle ScholarPubMed
3.Ostermeyer, J, Bircks, W, Krian, A, Sievers, G, Hilgenberg, F. Isolated atrioventricular discordance: report of two surgical cases with isolated ventricular inversion. J Thorac Cardiovasc Surg 1983; 86: 926929.CrossRefGoogle ScholarPubMed
4.Snider, AR, Enderlein, MA, Teitel, DF, Hirji, M, Heymann, MA. Isolated ventricular inversion: two-dimensional echocardiographic findings and a review of the literature. Pediatr Cardiol 1984; 5: 2733.CrossRefGoogle Scholar
5.Arciprete, P, Macartney, FJ, deLeval, M, Stark, J. Mustard's operation for patients with ventriculoarterial concordance: report of two cases and a cautionary tale. British Heart Journal 1985; 53: 443450:CrossRefGoogle Scholar
6.Baudet, EM, Hafez, A, Choussat, A, Roques, X. Isolated ventricular inversion with situs solitus: successful surgical repair. Ann Thorac Surg 1986; 41: 9194.CrossRefGoogle ScholarPubMed
7.Ranjit, MS, Wilkinson, JL, Mee, RBB. Discordant atrioventricularconnexion withconcordantventriculoarterial connextion (so-called “isolated ventricular inversion”) with usual atrial arrangement (situs solitus). International J Cardiology 1991; 31: 114117.CrossRefGoogle Scholar
8.Kurosawa, H, Imai, Y, Becker, AE. Congenitally corrected transposition with normally positioned atria, straddling mitral valve, and isolated posterior atrioventricular node and bundle. J Thorac Cardiovasc Surg 1990; 99: 312313.CrossRefGoogle ScholarPubMed
9.Yamaki, S, tezuka, F. Quantitative analysis of pulmonary vascular disease in complete transposition of the great arteries. Circulation 1976; 54: 805809.CrossRefGoogle ScholarPubMed
10.Anderson, RH, Wilkinson, JL. Isolated ventricular inversion with situs solitus. British Heart Journal 1975; 37: 12021204.CrossRefGoogle ScholarPubMed