Aortic reservoir function after arterial switch operation in elementary school-aged children.
BACKGROUND
After the arterial switch procedure, decreased distensibility of the aortic root has been reported, which means impaired aortic reservoir function of the coronary circulation, but there have been no reports regarding the relationship of this issue to myocardial perfusion. Therefore, in the present study the aortic reservoir function and coronary supply-demand balance were examined in patients after undergoing the arterial switch operation (ASO) around the time of entering elementary school.


RESULTS
Diastolic runoff (DR), which is the percentage of diastolic blood flow to total cardiac output, was measured as the index of aortic reservoir function. The subendocardial viability ratio was investigated as the index of coronary supply - demand balance. In the patient group, the aortic root was dilated (p<0.0001) and distensibility was impaired (p<0.0001) in comparison with an age-matched control group. However, there was no difference between the 2 groups in DR or subendocardial viability ratio.


CONCLUSIONS
Coronary supply - demand balance was preserved in the pediatric ASO patients, despite the aortic root dysfunction. The preserved DR suggests that dilatation of the aorta compensates for aortic reservoir function. Because large artery dysfunction predicts future cardiovascular diseases, careful follow-up is crucial.
Murakami
Tomoaki
T
Department of Pediatrics, Hokkaido University, Graduate School of Medicine, Sapporo, Japan. murat@med.hokudai.ac.jp
Takei
Kohta
K
Ueno
Michihiko
M
Takeda
Atsuhito
A
Yakuwa
Satoshi
S
Nakazawa
Makoto
M
D001011:Aorta / Q000503:physiopathology / Q000601:surgery*; D006348:Cardiac Surgical Procedures; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003326:Coronary Circulation; D004108:Dilatation, Pathologic; D004310:Double Outlet Right Ventricle / Q000503:physiopathology / Q000601:surgery*; D004548:Elasticity; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000503:physiopathology / Q000601:surgery*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D011651:Pulmonary Artery / Q000601:surgery; D011652:Pulmonary Circulation; D012039:Regional Blood Flow; D013334:Students; D014188:Transposition of Great Vessels / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome