Doppler echocardiographic comparison of haemodynamic results of one- and two-stage anatomic correction of complete transposition.

Eighteen children who had single-stage and 18 who had two-stage anatomic correction of complete transposition between the ages of 1 week and 3 years (mean 6.5 months) were investigated with pulsed and continuous wave Doppler ultrasound. Peak mitral flow velocities showed no significant difference from normal after single-stage correction, but were significantly higher than normal after two-stage correction (P less than 0.05). Peak tricuspid flow velocities were significantly higher than normal in both groups (P less than 0.02 and P less than 0.001). There was no significant difference in pulmonary artery flow velocities between the two groups, which were means (SD) of 214 (84) cm/sec after single-stage and 179 (87) cm/sec after two-stage repair. Peak velocities in the ascending aorta were within normal limits after single-stage correction, but were lower than normal in the two-stage group (P less than 0.02). Mild aortic regurgitation was detected in 22% of single-stage and 55% of two-stage patients (P = 0.043, 2P = 0.085). Both types of repair are associated with higher peak tricuspid flow velocities than normal and have a similar incidence of mild supravalvar pulmonary stenosis. Mitral flow velocities are higher than normal only after two-stage correction. Velocities in the ascending aorta are lower than normal and the incidence of mild aortic regurgitation appears to be increased after two-stage repair, probably due to dilatation of the aortic root following banding of the pulmonary trunk.