[Right ventricular function in patients with transposition of the great arteries after atrial inversion (Mustard procedure) (author's transl)]

Abstract

Twenty-nine patients with transposition of the great arteries (TGA) and intact ventricular septum underwent hemodynamic and angiocardiographic investigation 18,8 +/- 5,8 months after inflow correction (Mustard). The mean age at operation was 14,6 +/- 7,5 months and in all, a good anatomical result was achieved. The hemodynamic parameters such as cardiac index, pressures in all heart chambers as well as in the venous channels and arterial vessels were found within normal limits. The end-diastolic volume of the right ventricle (RVEDV) was closely correlated to body surface area (r = 0,697). It increased, however, more rapidly than in children with normal hearts. Mean RVEDV/m2 was 86 +/- 8 ml which is 123 +/- 10% of the normal values for children (70 +/- 13 ml) according to Graham et al. The mean ejection fraction (EF) of the right ventricle (58 +/- 7%) was only slightly below the normal range (65 +/- 7%). Thus, a good hemodynamic function of the RV can be assumed at least for the early postoperative years after a Mustard operation. It remains open, however, if the more rapid increase of RVEDV/m2 expresses the RV adjustment to the afterload of the systemic circulation or if this should be interpreted as an early sign of RV functional impairment.