Document Detail


Left ventricular wall stress and thickness in complete transposition of the great arteries. Implications for surgical intervention.
MedLine Citation:
PMID:  3982064     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The effects of volume and pressure loading of the left ventricle on posterior wall thickness and left ventricular wall stress in transposition of the great arteries were studied by combining echocardiographic and cardiac catheterization data. Pure volume loading with low left ventricular pressure resulted in little or no thickening of the left ventricular posterior wall (0.52 mm/log month). Pressure loading to levels above half of the right ventricular pressure was associated with thickening (2.80 to 3.89 mm/log month); however, further increase in pressure or volume load did not significantly alter the rate of thickening. Estimates of ventricular wall stress using a simple radius/wall thickness ratio may be misleading. However, if allowance is made for variable ventricular geometry and pressure, estimated wall stress is constant in transposition and is approximately equal to that reported previously in patients with normally related great arteries. The walls of low-pressure left ventricles in patients with transposition are demonstrably thinner than those of high-pressure left ventricles by age 1 to 3 months (2.67 versus 3.52 mm). Surgical procedures to use the left ventricle for systemic work, such as the arterial switch operation, should be performed in the first month of extrauterine life. Preparatory operations, if necessary prior to arterial switch, should load the left ventricle to greater than half systemic pressure.
Authors:
D A Danford; J C Huhta; H P Gutgesell
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  89     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  1985 Apr 
Date Detail:
Created Date:  1985-05-13     Completed Date:  1985-05-13     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  610-5     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Age Factors
Child
Child, Preschool
Echocardiography
Heart Ventricles / pathology,  physiopathology
Humans
Infant
Infant, Newborn
Models, Cardiovascular
Pressure
Stroke Volume
Transposition of Great Vessels / pathology,  physiopathology,  surgery*
Grant Support
ID/Acronym/Agency:
HL-07190/HL/NHLBI NIH HHS; HL31153/HL/NHLBI NIH HHS; RR-00188/RR/NCRR NIH HHS

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


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