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Asynchronous contraction of the 2 ventricles caused by ventricular pacing after a Fontan-type operation in a patient with a biventricular heart.
MedLine Citation:
PMID:  20226550     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
We treated a 6-year-old boy who had polysplenia syndrome and tetralogy of Fallot with a small right ventricle (RV), an atrial septal defect, a hemiazygos connection, and bilateral superior vena cava. Because the RV was too small for a biventricular repair to be performed, the patient underwent a total cavopulmonary shunt operation although his heart was biventricular and a pacemaker (VVI) had been implanted for management of the sick sinus syndrome complicated by polysplenia syndrome. After the operation, marked asynchronous contraction was noted between the morphological right and left ventricles and was probably responsible for the low cardiac output noted in this patient. In order to clarify the significance of the asynchronous contraction, we determined the cause of the low cardiac output by studying the time course of the volume changes in the morphological right and left ventricles during a cardiac cycle by using angiograms. In addition, we studied the interventricular flow dynamics by using pulsed-Doppler echocardiography. After a Fontan-type operation is performed on patients with a biventricular heart, the 2 ventricles may not function in perfect coordination when they have to work as 1 unit. These patients are likely to develop cardiac dysfunction due to interventricular to-and-fro flow dynamics. Asynchronous contraction between the 2 ventricles caused by abnormal interventricular conduction impaired the cardiac performance in the present case.
Authors:
Takashi Higaki; Chisato Kondo; Hirofumi Tomimatsu; Eiji Yamamura; Eiichi Yamamoto; Kyoko Konishi; Mitsugi Nagashima; Toshio Nakanishi
Publication Detail:
Type:  Journal Article     Date:  2010-03-11
Journal Detail:
Title:  International journal of cardiology     Volume:  150     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-07-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  e116-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Pediatric Cardiology, Heart Institute of Japan, Tokyo Women's Medical University, Tokyo, Japan; Department of Pediatric Cardiology, Stroke & Cardiovascular Center, Ehime University Hospital, Ehime, Japan.
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