Treatment of patients with transposition of great arteries and pulmonary vascular obstructive disease.
Twenty-two patients with transposition of the great arteries with or without ventricular septal defect and one with double outlet right ventricle, d-malposition, and severe pulmonary vascular obstructive disease were treated surgically. All were cyanosed and had very limited exercise tolerance. Preoperatively, systemic arterial oxygen saturation (SaO2) varied from 45 to 79% (mean 65), haemoglobin was 13 to 23 g/dl (mean 19). Pulmonary arteriolar resistance was 6.4 to 35 units m2 (mean 17). In the patients with a ventricular septal defect the Mustard operation was done without closure of the ventricular septal defect, and in the 3 patients with intact ventricular septum the Mustard operation was combined with creation of a ventricular septal defect. All patients survived the operation and improved. Postoperative SaO2 ranged from 75 to 96% (mean 89) and haemoglobin from 10.6 to 17.8 g/dl (mean 14.0). This improvement was significant (P less than 0.05). Five patients have had a postoperative cardiac catheterisation. The pulmonary arteriolar resistance remains high in all. Postoperative follow-up varies from 4 to 40 months (mean 14 months). So far there have been no late deaths and all patients remain improved.
D000293:Adolescent; D000403:Airway Resistance; D002648:Child; D002675:Child, Preschool; D006345:Heart Septal Defects, Ventricular / Q000150:complications; D006801:Humans; D006976:Hypertension, Pulmonary; D008171:Lung Diseases / Q000150:complications; D008722:Methods; D010100:Oxygen / Q000097:blood; D011183:Postoperative Complications; D011652:Pulmonary Circulation; D014188:Transposition of Great Vessels / Q000150:complications / Q000601:surgery*
D010100:Oxygen