Peterson R J, Franch R H, Fajman W A, Jones R H
Department of Surgery, Duke University Medical Center, Durham 27710.
J Thorac Cardiovasc Surg. 1988 Aug;96(2):227-36.
The capacity of the anatomic right ventricle to sustain normal function against systemic pressure long after atrial baffle procedures in patients with complete transposition of the great arteries remains unknown. Pulmonary and systemic ventricular function was measured by first-pass radionuclide studies in 11 children 7 +/- 3 years (+/- standard deviation) after baffle procedures. For comparison, similar measurements were made in eight patients with isolated congenitally corrected transposition of the great arteries and in 10 children in a control group. Exercise increased heart rate and cardiac index to similar levels in all three groups. Ventricular volumes were greater than control volumes in both groups with congenital heart disease. Exercise increased pulmonary ventricular ejection fraction in the control and congenitally corrected groups, but not in the surgically corrected group. Systemic ventricular ejection fraction increased during exercise in the control group, but remained unchanged in both transposition groups. These results show that cardiac index during exercise is maintained in patients after baffle procedures for complete transposition of the great arteries. However, pulmonary and systemic ventricular ejection fractions fail to increase with exercise, and ventricular volumes are markedly greater than normal.
在大动脉完全转位患者接受心房挡板手术后很长时间，解剖学右心室维持对抗体循环压力的正常功能的能力仍不清楚。通过首次通过放射性核素研究对11名年龄为7±3岁（±标准差）的儿童在接受挡板手术后的肺和体循环心室功能进行了测量。作为对照，对8例孤立性先天性矫正型大动脉转位患者和10名儿童对照组进行了类似测量。运动使三组患者的心率和心脏指数增加到相似水平。先天性心脏病的两组患者心室容积均大于对照组。运动使对照组和先天性矫正组的肺心室射血分数增加，但在手术矫正组中未增加。运动期间对照组的体循环心室射血分数增加，但在两个转位组中保持不变。这些结果表明，在大动脉完全转位患者接受挡板手术后，运动期间的心脏指数得以维持。然而，肺和体循环心室射血分数并未随运动增加，且心室容积明显大于正常。
