Up to 9 years of follow-up after anatomic correction of simple transposition of the great arteries.
For a continued assessment of the two-stage anatomic correction, we have evaluated the postoperative results in terms of clinical status, ECG, ventricular function, aortic root size and stiffness for up to 9 years in all 18 survivors. Weight and height were normal, the ECG was normal except for complete (n = 3) and incomplete (n = 11) right bundle branch block and supraventricular tachyarrhythmias post Blalock-Hanlon septectomy (n = 1) and p-wave abnormalities (n = 6). The pressures and ejection fraction of the left and right ventricles were within normal limits. The end-diastolic and endsystolic left ventricular volume and the muscle volume index were elevated. Six of 17 patients were outside the normal range of the left ventricular ejection fraction-endsystolic stress relationship. The diameter of the aortic root was larger than normal in all patients. There was a relation between the size of the patients at banding and the stiffness of the aortic root after anatomic correction. Patients with simple transposition of the great arteries up to 9 years after anatomic correction develop normally without atrio-ventricular conduction delay, arrhythmias or signs of coronary and myocardial insufficiency. The stiff and enlarged aortic roots do not seem to dilate. The reasons for the elevated left ventricular volumes and muscle volume indices are not clear at present. Primary anatomic correction may prevent these abnormalities.
Sievers
H H
HH
Department of Cardiovascular Surgery, University of Kiel, Federal Republic of Germany.
Lange
P E
PE
Wessel
A
A
Onnasch
D G
DG
Berger
F
F
Yacoub
M H
MH
Keck
E W
EW
Heintzen
P H
PH
Bernhard
A
A
D001011:Aorta / Q000502:physiology; D002037:Bundle-Branch Block / Q000503:physiopathology; D002675:Child, Preschool; D002932:Cineangiography; D004548:Elasticity; D004562:Electrocardiography; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011312:Pressure; D013318:Stroke Volume; D014188:Transposition of Great Vessels / Q000503:physiopathology / Q000601:surgery*