Document Detail


Long term follow-up of left ventricular performance and size of the great arteries before and after one- and two-stage arterial switch operation of simple transposition.
MedLine Citation:
PMID:  14643806     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Long-term angiographic evaluation of left ventricular performance and size of the great arteries after one-stage neonatal versus two-stage arterial switch operation (ASO) of simple transposition. METHODS: Analysis of cineangiographic studies obtained during the process of two-stage ASO for 34 patients and after neonatal repair for 52 patients. RESULTS: At early follow-up after two-stage ASO the left ventricular enddiastolic volume (LVEDV) was +1.8 standard deviations (S.D.) larger than LVEDV of control patients, but normalized completely (0.0 S.D.) at late follow-up. In contrast, after neonatal repair the LVEDV was always normal, and the median EF was significantly higher than after two-stage ASO (73 vs. 68%). The diameters of the native pulmonary annulus and sinus increased significantly after pulmonary artery banding to +4.5 and +4.8 S.D., respectively. After ASO, a significant decrease of the respective sizes occurred from early to late follow-up (annulus: +6.0 to +2.1 S.D.; sinus: +7.1 to +4.1 S.D.). After neonatal ASO the neoaortic annulus and sinus were only +1.5 and +2.7 S.D. larger than the comparable normal structures. The differences to the two-stage group were significant. In both groups, the neoaortic anastomosis had no diameters significantly different from normal. After one- and two-stage repair, the size of the neopulmonary annulus and sinus decreased similarly in both groups from early to late follow-up (annulus +0.9 to -2.4 S.D.; +0.3 to -2.8 S.D.; sinus: -0.7 to -1.6 S.D.; -0.7 to -1.8 S.D.). CONCLUSIONS: Neonatal ASO has definite advantages over two-stage repair concerning LV-performance and the degree of dilation of the neoaortic root. The significantly reduced size of the neopulmonary root after both procedures is remarkable, but fortunately mostly without clinical significance.
Authors:
Hans-Heiner Kramer; Jens Scheewe; Gunther Fischer; Anselm Uebing; Peter Harding; Friedrich Schmiel; Jochen Cremer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  24     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2003-12-03     Completed Date:  2004-03-01     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  898-905     Citation Subset:  IM    
Affiliation:
Department of Pediatric Cardiology, Christian Albrechts University, Schwanenweg 20, 24105, Kiel, Germany. kramer@pedcard.uni-kiel.de
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MeSH Terms
Descriptor/Qualifier:
Aorta / pathology
Cardiac Surgical Procedures / methods
Child, Preschool
Cineangiography
Follow-Up Studies
Heart Ventricles / pathology
Humans
Infant
Postoperative Period
Pulmonary Artery / pathology
Transposition of Great Vessels / pathology,  physiopathology,  surgery*
Treatment Outcome
Ventricular Function, Left*

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


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