[The evaluation of interval period to prepare the left ventricle for Jatene operation for simple transposition of the great arteries].
Laboratory studies indicate that it can be as short as one week after a first-stage operation to prepare the left ventricle for a subsequent second-stage arterial switch (Jatene operation) for simple transposition of the great arteries (TGA). In order to ascertain it, we evaluated the left ventricular (LV) function immediately after the first-stage procedure and late postoperatively by echocardiography and catheterization. There were 6 cases with simple TGA. The age at palliation was 6.6 +/- 4.5 (mean +/- SD) months, and the interval between the first-stage and Jatene operation was 16 days-16 months (6.7 +/- 6.4 months). All patients survived after arterial switch. In 2 early infant cases, arterial switch operation was performed with ventilatory support due to cardiac and respiratory failures 16 and 21 days after the first-stage operation respectively. LV end-diastolic dimension increased by 1 week and showed no change after 1 week (n = 4). LV ejection fraction was depressed from 0.84 +/- 0.03 preoperatively to 0.61 +/- 0.08 at 1-4 days after the first-stage operation but improved to 0.83 +/- 0.06 by 7-9 days after that (n = 4). LV end-diastolic posterior wall thickness increased to more than 4 mm in 3 infant cases, more than 3 mm in 2 early infant cases by 7 days. The results of catheterization after the first-stage operation were as follows (n = 5); left ventricular right ventricular peak systolic pressure ratio increased from 0.53 +/- 0.16 to 0.94 +/- 0.04 (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
Kato
H
H
Division of Cardiac Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Japan.
Akedo
H
H
Fukuda
H
H
Tanaka
T
T
Tsuchitani
Y
Y
Maeno
T
T
Matsushita
T
T
Shimazaki
Y
Y
Nakada
T
T
D000222:Adaptation, Physiological; D001807:Blood Vessel Prosthesis; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011651:Pulmonary Artery / Q000601:surgery*; D014188:Transposition of Great Vessels / Q000503:physiopathology / Q000601:surgery*; D016277:Ventricular Function, Left