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  • Colan, S D  (2)
  • 1985-1989  (2)
  • 1988  (2)
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  • 1985-1989  (2)
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  • 1988  (2)
  • 1
    Online Resource
    Online Resource
    Myocardial performance after arterial switch operation for transposition of the great arteries with intact ventricular septum.
    Ovid Technologies (Wolters Kluwer Health) ; 1988
    In:  Circulation Vol. 78, No. 1 ( 1988-07), p. 132-141
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 78, No. 1 ( 1988-07), p. 132-141
    Abstract: Left ventricular dimensions, wall thickness, wall stress, and indexes of afterload, preload, contractility, and early diastolic function, as well as regional wall motion, were determined by echocardiographic methods in patients with transposition of the great vessels after arterial switch operation and in age-matched normal controls. In patients evaluated early after surgery, body surface area-adjusted left ventricular dimensions were smaller, and wall thickness was increased compared with controls. Ventricular performance (fractional shortening) was normal in most patients but was abnormally low in 10%. Nevertheless, contractility was normal or augmented in all subjects, with a mean value higher than the control group. The reduction in systolic function was related to altered loading conditions with a combination of reduced afterload and preload combined with augmented contractility. These altered myocardial mechanics appeared to be secondary to routine therapy with digitalis and diuretics. Diastolic function was also normal with differences in the rate of peak filling and rate of wall thinning entirely attributable to differences in ventricular size and function, and normalized indexes of diastolic function were not different between patients and controls. Patients evaluated late after repair were found to have normal regional wall motion with no evidence to suggest regional dysfunction as might be seen with regional ischemia. Ventricular size, wall thickness, systolic function, afterload, preload, contractility, and early diastolic function were indistinguishable from control values. Indexes of diastolic function demonstrated the same relation to age, body surface area, and ventricular size and function in both patients and controls.(ABSTRACT TRUNCATED AT 250 WORDS)
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/01.CIR.78.1.132
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 1988
    detail.hit.zdb_id: 1466401-X
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    Online Resource
  • 2
    Online Resource
    Online Resource
    Midterm results after the arterial switch operation for transposition of the great arteries with intact ventricular septum: clinical, hemodynamic, echocardiographic, and electrophysiologic data.
    Ovid Technologies (Wolters Kluwer Health) ; 1988
    In:  Circulation Vol. 77, No. 6 ( 1988-06), p. 1333-1344
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 77, No. 6 ( 1988-06), p. 1333-1344
    Abstract: Although the short-term results of atrial level repair of transposition of the great arteries (TGA) are satisfactory, longer follow-up has disclosed a significant incidence of systemic right ventricular dysfunction and rhythm disturbances. The arterial switch operation (ASO) may represent a major improvement by restoring the left ventricle as the systemic ventricle and avoiding extensive atrial surgery. We have prospectively evaluated 49 consecutive survivors of ASO for TGA with intact ventricular septum (IVS) by clinical examination, echocardiography, cardiac catheterization, ambulatory electrocardiographic monitoring, and invasive electrophysiologic studies. The mean length of follow-up has been 29 +/- 14 (SD) months after surgery. All children are currently asymptomatic and on no medications. Severe supravalvular pulmonary stenosis (greater than 60 mm Hg) was present in five children, all of whom have undergone reoperation. No patient has severe supravalvular aortic obstruction. Mild degrees of supravalvular pulmonary or aortic obstruction have not progressed. Seven children (14%) have trivial or mild aortic regurgitation. Two children have proximal occlusion of the left anterior descending coronary artery with adequate retrograde collateral perfusion. One child had an electrocardiographic pattern of inferior myocardial infarction without evidence of ventricular dysfunction. Systemic (left) ventricular function is normal as measured by end-diastolic pressure (mean 7 +/- 6 mm Hg), ejection fraction (mean 68 +/- 6%), end-diastolic volume (mean 101 +/- 22% of predicted normal), and cardiac index (mean 4.7 +/- 1.3 liters/min/m2). Only one patient has sinus node dysfunction. There have been no late deaths. These early results are encouraging. We conclude that the arterial switch operation is currently the procedure of choice for neonates with TGA and IVS.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/01.CIR.77.6.1333
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 1988
    detail.hit.zdb_id: 1466401-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
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