The Yasui operation: A single institutional experience over 30 yearsCentral MessagePerspective
Objective: The Yasui operation was introduced in 1987 for patients with 2 adequate ventricles, a ventricular septal defect, and aortic atresia or interrupted aortic arch. Despite promising early outcomes, left ventricular outflow tract obstruction (LVOTO) remains a long-term concern. The purpose of...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-09-01
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| Series: | JTCVS Open |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666273623001833 |
| _version_ | 1797674131328598016 |
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| author | Christina L. Greene, MD Brandi Scully, MD Steven J. Staffa, MS Mariana Chavez, MD Kevin G. Friedman, MD Pedro del Nido, MD Luis G. Quinonez, MD Sitaram M. Emani, MD Christopher W. Baird, MD |
| author_facet | Christina L. Greene, MD Brandi Scully, MD Steven J. Staffa, MS Mariana Chavez, MD Kevin G. Friedman, MD Pedro del Nido, MD Luis G. Quinonez, MD Sitaram M. Emani, MD Christopher W. Baird, MD |
| author_sort | Christina L. Greene, MD |
| collection | DOAJ |
| description | Objective: The Yasui operation was introduced in 1987 for patients with 2 adequate ventricles, a ventricular septal defect, and aortic atresia or interrupted aortic arch. Despite promising early outcomes, left ventricular outflow tract obstruction (LVOTO) remains a long-term concern. The purpose of this study is to report our institutional experience with the Yasui operation. Methods: We retrospectively reviewed all patients undergoing the Yasui operation between 1989 and 2021. Results are reported as median with interquartile range (IQR). Results: Twenty-five patients underwent a Yasui operation (19 primary), at 11 days (IQR, 7-218 days) of life and weight of 3 kg (IQR, 2.8-4.1 days). Fundamental diagnosis was ventricular septal defect/interrupted aortic arch in 11 patients and ventricular septal defect/aortic atresia in 14. Follow-up was 96% (24 out of 25) at 5 years (IQR, 1.4-14.7) with 92% survival. Freedom from LVOTO reoperation was 91% at late follow-up with 2 patients requiring baffle revision at 6 and 9 years. Latest echocardiogram showed 100% of patients had normal biventricular function and 87% (20 out of 23) less than mild LVOTO at 5 years (IQR, 2.3-14.9). Diagnosis, aortic valve morphology, and material used were not predictors of LVOTO. Freedom from right ventricle-to-pulmonary artery conduit reoperation was 48% at a median of 5 years (IQR, 1.4-14.7). Conduit type was not a predictor of reintervention. Conclusions: The Yasui operation can be performed with low morbidity and mortality in patients with 2 acceptable-size ventricles and aortic atresia or interrupted aortic arch with severe LVOTO. Despite some burden of reoperation, midterm reoperation for LVOTO is not common and ventricular function is preserved. |
| first_indexed | 2024-03-11T21:54:41Z |
| format | Article |
| id | doaj.art-5ebc2a9a636f42a981fa011e654e55c1 |
| institution | Directory Open Access Journal |
| issn | 2666-2736 |
| language | English |
| last_indexed | 2024-03-11T21:54:41Z |
| publishDate | 2023-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTCVS Open |
| spelling | doaj.art-5ebc2a9a636f42a981fa011e654e55c12023-09-26T04:12:35ZengElsevierJTCVS Open2666-27362023-09-0115361367The Yasui operation: A single institutional experience over 30 yearsCentral MessagePerspectiveChristina L. Greene, MD0Brandi Scully, MD1Steven J. Staffa, MS2Mariana Chavez, MD3Kevin G. Friedman, MD4Pedro del Nido, MD5Luis G. Quinonez, MD6Sitaram M. Emani, MD7Christopher W. Baird, MD8Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Mass; Address for reprints: Christina L. Greene, MD, Seattle Children's Hospital, 4800 Sand Point Way NE, RC.2.820, Seattle, WA 98105.Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MassDepartment of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MassDepartment of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MassDepartment of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, MassDepartment of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MassDepartment of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MassDepartment of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MassDepartment of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MassObjective: The Yasui operation was introduced in 1987 for patients with 2 adequate ventricles, a ventricular septal defect, and aortic atresia or interrupted aortic arch. Despite promising early outcomes, left ventricular outflow tract obstruction (LVOTO) remains a long-term concern. The purpose of this study is to report our institutional experience with the Yasui operation. Methods: We retrospectively reviewed all patients undergoing the Yasui operation between 1989 and 2021. Results are reported as median with interquartile range (IQR). Results: Twenty-five patients underwent a Yasui operation (19 primary), at 11 days (IQR, 7-218 days) of life and weight of 3 kg (IQR, 2.8-4.1 days). Fundamental diagnosis was ventricular septal defect/interrupted aortic arch in 11 patients and ventricular septal defect/aortic atresia in 14. Follow-up was 96% (24 out of 25) at 5 years (IQR, 1.4-14.7) with 92% survival. Freedom from LVOTO reoperation was 91% at late follow-up with 2 patients requiring baffle revision at 6 and 9 years. Latest echocardiogram showed 100% of patients had normal biventricular function and 87% (20 out of 23) less than mild LVOTO at 5 years (IQR, 2.3-14.9). Diagnosis, aortic valve morphology, and material used were not predictors of LVOTO. Freedom from right ventricle-to-pulmonary artery conduit reoperation was 48% at a median of 5 years (IQR, 1.4-14.7). Conduit type was not a predictor of reintervention. Conclusions: The Yasui operation can be performed with low morbidity and mortality in patients with 2 acceptable-size ventricles and aortic atresia or interrupted aortic arch with severe LVOTO. Despite some burden of reoperation, midterm reoperation for LVOTO is not common and ventricular function is preserved.http://www.sciencedirect.com/science/article/pii/S2666273623001833Yasuibiventricular repairaortic atresiainterrupted aortic archleft ventricular outflow tract obstruction |
| spellingShingle | Christina L. Greene, MD Brandi Scully, MD Steven J. Staffa, MS Mariana Chavez, MD Kevin G. Friedman, MD Pedro del Nido, MD Luis G. Quinonez, MD Sitaram M. Emani, MD Christopher W. Baird, MD The Yasui operation: A single institutional experience over 30 yearsCentral MessagePerspective JTCVS Open Yasui biventricular repair aortic atresia interrupted aortic arch left ventricular outflow tract obstruction |
| title | The Yasui operation: A single institutional experience over 30 yearsCentral MessagePerspective |
| title_full | The Yasui operation: A single institutional experience over 30 yearsCentral MessagePerspective |
| title_fullStr | The Yasui operation: A single institutional experience over 30 yearsCentral MessagePerspective |
| title_full_unstemmed | The Yasui operation: A single institutional experience over 30 yearsCentral MessagePerspective |
| title_short | The Yasui operation: A single institutional experience over 30 yearsCentral MessagePerspective |
| title_sort | yasui operation a single institutional experience over 30 yearscentral messageperspective |
| topic | Yasui biventricular repair aortic atresia interrupted aortic arch left ventricular outflow tract obstruction |
| url | http://www.sciencedirect.com/science/article/pii/S2666273623001833 |
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