title: Impact of left ventricular function on early outcomes after arterial switch for D-transposition of great arteries with intact ventricular septum.
abstract: OBJECTIVE
  The aim of this study was to assess the utility of tissue Doppler echocardiography in evaluating the pre-operative left ventricular systolic function and in turn its impact on early post-operative outcomes following arterial switch operation for transposition of great arteries with intact ventricular septum.
  
  
  BACKGROUND
  Pre-operative left ventricular function is an important determinant of outcomes following arterial switch.
  
  
  METHODS
  We studied 19 patients with transposition and intact septum who had undergone one stage arterial switch operation. All had a pre-operative echocardiogram.
  
  
  RESULTS
  The left ventricle was adequate in 15 infants as per the dimensions and shape for age. The early outcomes of surgery were assessed on the basis of their pre operative tissue Doppler. There were 7 (40%) patients with reduced S wave velocities (2.62 +/- 0.84 cm/sec) and lower isovolumetric myocardial acceleration (1.2 +/- 0.5 m/sec(2)) reflecting systolic dysfunction. Those patients with reduced S wave velocities and isovolumetric acceleration correlated with poor early surgical outcomes in terms of longer duration of ventilation ( p< 0.001), longer duration of inotropes ( p< 0.00001) and higher mortality ( p < 0.001).
  
  
  CONCLUSIONS
  The tissue Doppler echocardiography is a more sensitive modality to evaluate ventricular performance than the 2D-echo. It can be used as a sensitive predictor of outcomes following arterial switch.
authors.affiliation: Department of Cardiology, Narayana Hrudayalaya, Bommasandra industrial area, Anekal Taluk, Bangalore-560099. srili2881967@yahoo.com
authors.forename: Srilakshmi M
authors.initials: SM
authors.lastname: Adhyapak
authors.forename: Bijay K
authors.initials: BK
authors.lastname: Mahala
authors.forename: Suresh V
authors.initials: SV
authors.lastname: Pujar
authors.forename: Pradeep K
authors.initials: PK
authors.lastname: Shetty
authors.forename: Rajesh
authors.initials: R
authors.lastname: Sharma
mesh_terms: D002316:Cardiotonic Agents / Q000627:therapeutic use; D005260:Female; D006346:Heart Septum / Q000000981:diagnostic imaging* / Q000473:pathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010865:Pilot Projects; D011300:Preoperative Care; D013599:Systole; D013997:Time Factors; D014188:Transposition of Great Vessels / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D016277:Ventricular Function, Left
chemical_list: D002316:Cardiotonic Agents