Abstract
Double chamber right ventricle (DCRV) repair surgery requires excision of anomalous
obstructive muscular or fibromuscular bundles in the right ventricular outflow tract
(RVOT). Owing to close proximity of key structures in the RVOT, the surgery is extremely
challenging and requires precise resection. Under-resection of the muscle bands can
lead to significant residual gradients in the post operative period, whereas over-enthusiastic
resection can cause iatrogenic injury to surrounding structures. Various techniques
like Hegar sizing by the surgeons, direct chamber pressure measurement, transesophageal
echocardiography (TEE) and epicardial echocardiography can guide the surgeons about
the adequacy of repair. TEE has a crucial role to play at each step as it can precisely
determine the exact site of obstruction in the preoperative period. Postoperatively
it is helpful in determining the adequacy of surgical repair and identification of
inadvertent iatrogenic complications.
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