Hausdorf G, Grävinghoff L, Keck E W, Sieg K, Radley-Smith R, Yacoub M
Z Kardiol. 1985 Feb;74(2):121-9.
The major theoretical advantage of anatomic correction of transposition of the great arteries compared with intraatrial repair is that the left ventricle becomes the systemic pump. In 10 patients we analysed 5-12 months after anatomic correction the left ventricular echocardiographic pressure-dimension loop, meridional wall stress and left ventricular stiffness from the simultaneous recordings of the left ventricular pressure and M-mode echocardiogram. The low left ventricular diameters, left ventricular hypertrophy in 4 patients, and increased peak meridional wall stress in 3 patients indicate that left ventricular adaption to systemic impedance is still incomplete 5-12 months after anatomic correction. The cycle efficiency was reduced in 2 patients, indicating incoordinate left ventricular contraction and relaxation. In one of these patients the left ventricular stiffness was severely increased, while in another patient there was a slight increase in left ventricular stiffness. In all patients the right ventricular internal diameter was increased due to the long-standing preoperative pressure and volume overload.
与心房内修复相比，大动脉转位解剖矫正的主要理论优势在于左心室成为体循环泵。我们对10例患者在解剖矫正术后5至12个月进行了分析，通过同步记录左心室压力和M型超声心动图，得出左心室超声心动图压力-维度环、经壁应力和左心室僵硬度。左心室直径较小，4例患者出现左心室肥厚，3例患者经壁应力峰值增加，这表明解剖矫正术后5至12个月，左心室对体循环阻抗的适应仍不完全。2例患者的循环效率降低，提示左心室收缩和舒张不协调。其中1例患者左心室僵硬度严重增加，另1例患者左心室僵硬度略有增加。由于术前长期存在压力和容量超负荷，所有患者的右心室内径均增大。
