European Journal of Cardio-Thoracic Surgery, Vol 2, 318-323, Copyright © 1988 by European Association for Cardio-thoracic Surgery
Up to 9 years of follow-up after anatomic correction of simple transposition of the great arteries
HH Sievers, PE Lange, A Wessel, DG Onnasch, F Berger, MH Yacoub, EW Keck, PH Heintzen and A Bernhard
Department of Cardiovascular Surgery, University of Kiel, Federal Republic of Germany.
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.
