Long term ventricular performance after intra-atrial correction of transposition: left ventricular filling is the major limitation. Issue 4 (1st October 1997)

• Record Type: Journal Article
• Authors: Reich, Oleg; Voříšková, Marie; Ruth, Cyril; Krejčíř, Miroslav; Marek, Jan; Škovránek, Jan; Hučín, Bohumil; Šamánek, Milan
• Is Part Of: Heart. Volume 78:Issue 4(1997)
• Page Start: 376
• Page End: 381
• Publication Date: 1997-10-01
• Subjects: congenital heart defects -- transposition of the great arteries -- radionuclide ventriculography -- ventricular function; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/hrt.78.4.376
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Objective: To establish the incidence of systolic and diastolic dysfunction of the right and left ventricle in a large cohort of patients after Mustard or Senning operations and to assess changes in the incidence on long term follow up. Design: Postoperative case-control study using radionuclide ventriculography. Ejection fractions, peak filling rates, rapid filling periods and fractions, slow filling periods and fractions, and atrial contraction periods and fractions were studied. Setting: Tertiary care centre, ambulatory and hospital inpatient care. Patients: A convenience sample of 153 patients studied at median age of 6.9 years (median 4.4 years after surgery). In 99 cases another study was available at a median age of 15.3 years (median 13 years after surgery and 8.8 years after the first study). Results: Respective incidences of dysfunction in the first and the second study were as follows: ejection fraction –right ventricle 7.8% and 8.1%, left ventricle 7.2% and 10.1%; peak filling rate –right ventricle 0% and 4.2%, left ventricle 14.3% and 29.5% (p < 0.05); rapid filling period – right ventricle 18.3% and 11.6%, left ventricle 30.2% and 30.5%; slow filling period —right ventricle 4.8% and 3.2%; left ventricle 11.9% and 23.2%; atrial contraction period –right ventricle 0.8% and 4.2%, left ventricle 15.1% and 26.3%; rapid filling fraction –right ventricle both 0%, left ventricle 82.5% and 79.0%; slow filling fraction –right ventricle 0.8% and 4.2%, left ventricle 37.3% and 30.5%; atrial contraction fraction –right ventricle both 0%, left ventricle 79.4% and 71.6%. Conclusions: The incidence of systolic ventricular dysfunction is 8% (right ventricle) and 10% (left ventricle) 13 years after surgery, without a significant increase over the eight year follow up. Diastolic filling is abnormal in up to 80% of patients and left ventricular peak filling rate deteriorates with time.