Document Detail

Determinants of exercise function following univentricular versus biventricular repair for pulmonary atresia/intact ventricular septum.
MedLine Citation:
PMID:  16728229     Owner:  NLM     Status:  MEDLINE    
This study aimed to determine whether the exercise capacity of patients with pulmonary atresia/intact ventricular septum (PA/IVS) who have undergone biventricular repair is superior to that of patients with single ventricle repairs and to account for any differences. PA/IVS is generally treated with either biventricular (outflow tract reconstruction) or univentricular (Fontan) palliation. Although biventricular repair is believed to result in superior exercise function, this theory is untested. Symptom-limited programmed bicycle ergonometry with expiratory gas analysis was prospectively performed on all patients with PA/IVS >7 years old seen over 18 months. Nineteen biventricular and 10 Fontan patients (mean age 16.5 +/- 6.5 vs 12.7 +/- 5.0 years, p = 0.12) were enrolled. The exercise capacity of biventricular patients was not statistically superior to that of Fontan patients (predicted peak VO2 83.5 +/- 21% vs 76.0 +/- 17.5%, p = 0.34), although chronotropic function and ventilatory efficiency were significantly better in the former. The peak exercise capacity varied widely within each group, and there was considerable overlap between biventricular and Fontan patients. Within groups, imaging studies did not reliably predict exercise capacity. Most patients in each group had subnormal peak VO2, and there was a trend toward impaired performance with increasing age regardless of type of repair. In conclusion, biventricular repair may not guarantee superior exercise performance over single-ventricle palliation in PA/IVS. Regardless of repair type, aerobic capacity may deteriorate with age and is not reliably predicted by noninvasive imaging. These findings underscore the need for a quantitative, proactive approach to the assessment and preservation of exercise function.
Darshak M Sanghavi; Michael Flanagan; Andrew J Powell; Tracy Curran; Sarah Picard; Jonathan Rhodes
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2006-04-19
Journal Detail:
Title:  The American journal of cardiology     Volume:  97     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-05-26     Completed Date:  2006-06-20     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1638-43     Citation Subset:  AIM; IM    
Division of Pediatric Cardiology, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
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MeSH Terms
Cardiac Surgical Procedures / methods*
Exercise Test
Exercise Tolerance / physiology*
Follow-Up Studies
Heart Septal Defects, Ventricular / physiopathology*,  surgery
Heart Ventricles / physiopathology,  surgery*
Prospective Studies
Pulmonary Atresia / physiopathology*,  surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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