| 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. | |
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MedLine Citation:
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PMID: 14643806 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Hans-Heiner Kramer; Jens Scheewe; Gunther Fischer; Anselm Uebing; Peter Harding; Friedrich Schmiel; Jochen Cremer |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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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:
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Created Date: 2003-12-03 Completed Date: 2004-03-01 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8804069 Medline TA: Eur J Cardiothorac Surg Country: England |
Other Details:
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Languages: eng Pagination: 898-905 Citation Subset: IM |
Affiliation:
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Department of Pediatric Cardiology, Christian Albrechts University, Schwanenweg 20, 24105, Kiel, Germany. kramer@pedcard.uni-kiel.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aorta
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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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