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The potentially obstructive subaortic region and banding of the pulmonary trunk—selected observations in the patient considered for a Fontan procedure

Published online by Cambridge University Press:  19 August 2008

Robert M. Freedom ,
Teiji Akagi  and
Leland N. Benson
Robert M. Freedom*
Affiliation:
From the Division of Cardiology, The Hospital for Sick Children, Toronto
Teiji Akagi
Affiliation:
From the Division of Cardiology, The Hospital for Sick Children, Toronto
Leland N. Benson
Affiliation:
From the Division of Cardiology, The Hospital for Sick Children, Toronto
*
Correspondence to Dr. Robert M. Freedom, The Hospital for Sick Children, Division of Cardiology, Room 1503, 555 University Avenue, Toronto, Ontario, CanadaM5G 1X8. Tel. 416-598-6132; Fax. 416-598-7547.
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Summary

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There is a clear and present danger for the patient considered for Fontan's operation in the presence of excessive ventricular hypertrophy and/or mass. Such ventricular hypertrophy and/or mass probably reflects singly, or in combination, banding of the pulmonary trunk and subaortic stenosis, as well as other factors. While one can construct a number of therapeutic algorithms for patients seen at various ages with a restrictive ventricular septal defect and subaortic stenosis in the setting of double inlet left ventricle and discordant ventriculoarterial connections, the optimal management should be to minimize the potential risks for development of subaortic stenosis and excessive ventricular hypertrophy and/or mass.

Keywords

Univentricular atrioventricular connectionsdouble inlet left ventricletricuspid atresiabanding of the pulmonary trunk
Type
Editorial Comment
Information
Cardiology in the Young , Volume 3 , Issue 2 , April 1993 , pp. 91 - 97
Copyright
Copyright © Cambridge University Press 1993

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