完全天血管転位症に対する解剖学的根治手術2症例の術後心機能

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Cardiac function was evaluated in two patients with transposition of the great arteries after anatomical correction (Jatene operation). One (case 1) was a 6-year-old boy with transposition of the great arteries with ventricular septal defect, 5 years and 11 months after Jatene operation. The other (case 2) was 2-year-old boy with a Taussig-Bing anomaly of the type of transposition of the great arteries, 1 year and 9 months after Jatene operation. Pressure gradient between right ventricle and pulmonary artery was 18 mmHg in case 1, but there were no pressure gradients between ventricles and great arteries in case 2. Aortic regurgitation and stenosis at the anastomosed sites of pulmonary arteries, aorta, and coronary arteries were not found angiographically. Small aortic aneurysm was found in both cases. Mild degree of mitral regurgitation, which was detected preoperatively, still remained in case 2. Cardiac index was 3.80l/min/m^2 and 4.31l/min/m^2 respectively. Left ventricular end-diastolic volume was 115% and 160% of the normal value. Left ventricular ejection fraction was 0.59 and 0.52. Right ventricular end-diastolic volume was 129% and 299% of normal. Right ventricular ejection fraction was 0.50 and 0.40. Left ventricular volume and ejection fraction was within normal range in case 1. Left ventricle was dilated and its ejection fraction was slightly depressed in case 2. This was due to volume over load by mitral regurgitation. The right ventricular volume was increased slightly in case 1 and significantly in case 2. Its ejection fraction was depressed slightly in case 1 and severely in case 2. This seemes to be due to large right ventriculotomy in both cases and pulmonary hypertension as high as systemic pressure in case 2. Cardiac function after anatomic correction for transposition of the great arteries was almost normal in the absence of residual disease or pulmonary hypertension.
日本小児外科学会の論文
1984-04-20

完全天血管転位症に対する解剖学的根治手術2症例の術後心機能

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