Lincoln C, Redington A N, Li K, Mattos S, Shinebourne E A, Rigby M L
Br Heart J. 1986 Sep;56(3):259-66. doi: 10.1136/hrt.56.3.259.
Thirty three patients were followed up after anatomical correction of transposition of the great arteries or double outlet right ventricle and subpulmonary ventricular septal defect (Taussig-Bing anomaly). There were no late deaths and clinical progress was excellent. Cardiac catheterisation was performed in 17 patients two weeks to 44 months after operation. There were six patients with simple transposition, six with complete transposition and large ventricular septal defect, and five with the Taussig-Bing anomaly. Pressure gradients across the right ventricular outflow tract ranged from 5 to 72 mm Hg, being greater than 40 mm Hg in five patients. No patient was shown to have important valvar regurgitation and in 15 patients the coronary anastomoses were widely patent. Left ventricular function was assessed from digitised ventriculograms. Ventricular volume, shape, and ejection fraction were all normal for the group although patients with complex transposition showed a significantly lower mean (SD) ejection fraction than those with simple transposition (62(9) vs 77(9]. Analysis of regional wall motion showed a totally normal pattern in four patients; however, in seven patients a characteristic abnormality of anterior hypokinesis with delayed onset of inward wall motion was seen. Anatomical correction of transposition of the great arteries and the Taussig-Bing anomaly can be performed with satisfactory anatomical and functional results. The implications of the left ventricular wall motion abnormalities is unknown.
33例大动脉转位或右心室双出口合并肺动脉下室间隔缺损(陶西格-宾氏畸形)患者接受解剖矫正术后进行了随访。无晚期死亡病例,临床进展良好。17例患者在术后2周至44个月进行了心导管检查。其中6例为单纯性转位,6例为完全性转位合并大型室间隔缺损,5例为陶西格-宾氏畸形。右心室流出道的压力阶差为5至72毫米汞柱,5例患者大于40毫米汞柱。未发现患者有严重的瓣膜反流,15例患者的冠状动脉吻合口广泛通畅。通过数字化心室造影评估左心室功能。该组患者的心室容积、形状和射血分数均正常,尽管复杂转位患者的平均(标准差)射血分数显著低于单纯转位患者(62(9)对77(9))。局部室壁运动分析显示4例患者完全正常;然而,7例患者可见特征性的前壁运动减弱伴室壁向内运动延迟开始的异常。大动脉转位和陶西格-宾氏畸形的解剖矫正可取得满意的解剖和功能结果。左心室壁运动异常的意义尚不清楚。