Two-stage anatomic correction of complete transposition of the great arteries: ventricular volumes and muscle mass

Abstract

Between 1976 and 1981, 27 patients with complete transposition of the great arteries, ranging from one month to 2 1/2 years, underwent two-stage anatomic correction and 7 patients first-stage operation only. There were three early deaths after the first-stage and five after the second-stage operation and no late deaths. In seven patients the results of repeat cardiac catheterization including quantitative analysis of ventricular angiocardiograms at the different stages of the procedure were available. In these patients peak systolic pressure in the left ventricle rose to systemic levels after banding of the pulmonary artery. Left ventricular end-diastolic and stroke volumes decreased to normal levels without significant reduction of arterial oxygen saturation. One to 2 1/2 years after anatomic correction left and right ventricular function was normal, as judged by normal end-diastolic pressure, ejection fraction and ratio left ventricular muscle volume/end-diastolic volume. Minimal aortic regurgitation in five patients, mild mitral insufficiency in two and a small VSD in two contributed to elevated end-diastolic volumes of the left ventricle, observed in six patients, and of the right ventricle, found in two patients. The aortic and coronary anastomoses appeared to grow normally.