Results over a Two-year Period in Complete Transposition of the Great Arteries After Mustard's Procedure : Symposium on Long-term Results Following Surgical Operation of Heart Disease
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概要
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Postoperative echocardiographic, hemodynamic and cineangiographic findings were obtained on 27 cases of complete transposition of the great arteries (TGA) which had undergone Mustard's procedure over two years ago. A majority of patients with TGA have abnormal right ventricular function as indicated by an increased right ventricular end-diastolic volume (RVEDV) and a low ejection fraction (RVEF). Despite this depressed RVEF, normal or increased RV output is maintained through an increased RVEDV. The postoperative right ventricular end-diastolic dimension (RVDd) averaged 275 ± 70% of normal and the left ventricular end-diastolic dimension (LVDd) averaged 75 ± 11% of normal. The postoperative ratio of RPEP/ RVET was greater (0.44 ± 0.06) than normal value (0.34 ± 0.06) for systemic circuit, whereas the postoperative ratio of LPEP/LVET was similar (0.23 ± 0.06) to normal value (0.22 ± 0.05) for pulmonary circuit. The ventricular cavity dimensions and ratios of PEP/ET were appropriate for the physiologic role of the ventricles rather than their morphologic identity. A variety of valve motion abnormalities were noted ;these included diastolic flutter of the mitral valve in 94% of patients, prolapse in 50% and systolic anterior motion (SAM) in 50%, while diastolic flutter of the tricuspid valve in 75% of patients, prolapse in 100% and SAM in 19%. Systolic flutter of the semilunar valve was found in half patients and paradoxical septal motion was found in all patients. Atrioventricular valve motion abnormalities presumably caused by the decrease of atrial volume or compliance or the increase of RV pressure were observed at high rate but at least until 8 years after Mustard's procedure, the function of those valves had been satisfactory. Echocardiographic dimensions or systolic time intervals (STI) were considered to be useful not only for the evaluation of LV performance but also for the evaluation of RV performance or dynamic status of pulmonary circulation after Mustard's operation for TGA. The finding of a great number of echocardiographic abnormalities in TGA suggests that these echocardiographic features are to be expected after Mustard's procedure.
- 社団法人日本循環器学会の論文
- 1980-12-20
著者
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SHIROTANI Hitoshi
Department of Cardiovascular Surgery, Kinki University School of Medicine
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Shirotani Hitoshi
Department Of Cardiovascular Surgery Kinki University School Of Medicine
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Shirotani Hitoshi
Department Of Cardiovascular Surgery Hyogo Kenritsu Amagasaki Hospital
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