Sievers H H, Lange P E, Wessel A, Onnasch D G, Berger F, Yacoub M H, Keck E W, Heintzen P H, Bernhard A
Department of Cardiovascular Surgery, University of Kiel, Federal Republic of Germany.
Eur J Cardiothorac Surg. 1988;2(5):318-23. doi: 10.1016/1010-7940(88)90005-x.
For a continued assessment of the two-stage anatomic correction, we have evaluated the postoperative results in terms of clinical status, ECG, ventricular function, aortic root size and stiffness for up to 9 years in all 18 survivors. Weight and height were normal, the ECG was normal except for complete (n = 3) and incomplete (n = 11) right bundle branch block and supraventricular tachyarrhythmias post Blalock-Hanlon septectomy (n = 1) and p-wave abnormalities (n = 6). The pressures and ejection fraction of the left and right ventricles were within normal limits. The end-diastolic and endsystolic left ventricular volume and the muscle volume index were elevated. Six of 17 patients were outside the normal range of the left ventricular ejection fraction-endsystolic stress relationship. The diameter of the aortic root was larger than normal in all patients. There was a relation between the size of the patients at banding and the stiffness of the aortic root after anatomic correction. Patients with simple transposition of the great arteries up to 9 years after anatomic correction develop normally without atrio-ventricular conduction delay, arrhythmias or signs of coronary and myocardial insufficiency. The stiff and enlarged aortic roots do not seem to dilate. The reasons for the elevated left ventricular volumes and muscle volume indices are not clear at present. Primary anatomic correction may prevent these abnormalities.
为持续评估两阶段解剖矫正术，我们对所有18名幸存者的术后结果进行了长达9年的临床状态、心电图、心室功能、主动脉根部大小和硬度评估。体重和身高正常，除了完全性（n = 3）和不完全性（n = 11）右束支传导阻滞、Blalock-Hanlon房间隔切除术后室上性快速心律失常（n = 1）以及P波异常（n = 6）外，心电图正常。左、右心室压力和射血分数均在正常范围内。左心室舒张末期和收缩末期容积以及心肌容积指数升高。17名患者中有6名超出左心室射血分数-收缩末期压力关系的正常范围。所有患者的主动脉根部直径均大于正常。缩窄时患者的体型与解剖矫正术后主动脉根部的硬度之间存在关联。大动脉转位患者在解剖矫正术后长达9年可正常发育，无房室传导延迟、心律失常或冠状动脉和心肌功能不全的迹象。僵硬且增大的主动脉根部似乎没有扩张。目前尚不清楚左心室容积和心肌容积指数升高的原因。一期解剖矫正可能预防这些异常情况。
