Lecompte Procedure in Complex Congenital Heart Diseases.
- Author:
Yong Jin KIM
1
;
Gyung Hwan KIM
;
Suk Jae LEE
;
Hyun SONG
;
Sam Se OH
;
Jeong Ryul LEE
;
Joon Rhyang RHO
;
Kyung Phill SUH
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Heart defect;
congenital;
Lecompte procedure;
Ventricular outflow tract obstruction;
right
- MeSH:
Anoxia;
Aorta;
Constriction;
Double Outlet Right Ventricle;
Female;
Heart Diseases*;
Heart Failure;
Heart Septal Defects, Ventricular;
Heart Ventricles;
Heart*;
Humans;
Male;
Mortality;
Pulmonary Artery;
Pulmonary Valve Stenosis;
Reoperation;
Risk Factors;
Seoul;
Sepsis;
Survival Rate;
Transposition of Great Vessels
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
1998;31(7):660-667
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: This study is to evaluate the effectiveness and application of Lecompte procedure as a treatment for various complex cardiac anomalies with pulmonary outflow tract obstruction. Methods: Between July 1988 and December 1997, 44 patients underwent Lecompte procedure in Seoul National University Children's Hospital. The male to female ratio was 24 to 20 and the mean age was 29.2 months (range, 3 to 83). Of these patients, 28 (63.6%) had transposition of great arteries with ventricular septal defect and pulmonary stenosis (or pulmonary atresia), 14 (31.8%) had double outlet right ventricle with pulmonary stenosis (or pulmonary atresia), and so on. The principles of the technique are 1) extension of the ventricular septal defect or conal resection, 2) construction of a intracardiac tunnel connecting the left ventricle to the aorta, and 3) direct connection, without a prosthetic conduit, of the pulmonary trunk to the right ventricle. RESULTS: There were 3 in-hospital deaths and their causes were sustained hypoxia, myocardial failure, and sepsis, respectively. There was 1 late death due to sepsis. Reoperations were performed in 6 patients who had pulmonary outflow tract obstructions (4 cases), residual muscular ventricular septal defect (1 case), and recurrent septic vegetation (1 case). The cumulative survival rates by the Kaplan-Meier method were 92.7%, 92.7%, and 92.7% at 1, 2, and over 4 years. The reoperation free survival rates were 92.7%, 92.7%, and 70.2% at 1, 3, and over 5 years. Among the risk factors for the operative death, aortic cross clamping time had statistical significance (p<0.05) and all the risk factors for the recurrent pulmonary stenosis such as age, pulmonary artery index, and materials used for the pulmonary outflow tract reconstruction had no statistical significance (p>0.05). CONCLUSIONS: Our review suggests that Lecompte procedure is an effective treatment modality for various complex cardiac anomalies with pulmonary outflow tract obstruction. Repair in early age is possible and the rates of mortality and morbidity are also acceptable.
