D J Penny1, M L Rigby, A N Redington. 1. Department of Paediatric Cardiology, Royal Brompton National Heart and Lung Hospital, London.
Abstract
OBJECTIVE: To assess whether regional abnormalities of ventricular function are present in patients after the Fontan operation and to explore the implications of any such abnormalities for ventricular filling. DESIGN AND PATIENTS: Prospective study in which 25 patients after the Fontan operation were compared with 25 healthy controls and 12 patients with a univentricular atrioventricular connection, before the Fontan operation. INTERVENTIONS: Doppler echocardiography, with simultaneous electrocardiogram, phonocardiogram, and respirometer. RESULTS: Isovolumic relaxation time was significantly longer in patients after the Fontan operation than in normal children (p less than 0.001) or the preoperative patients (p = 0.001). Systolic intraventricular flow was detected in 60% of patients after the Fontan operation and in 42% of preoperative patients. After the Fontan operation 80% of patients showed intraventricular flow during isovolumic relaxation compared with 8% of normal children and none of the preoperative patients. CONCLUSIONS: Incoordinate ventricular relaxation is common after the Fontan operation. This may have important implications for ventricular diastolic filling, pulmonary blood flow, and cardiac output in these patients.
OBJECTIVE: To assess whether regional abnormalities of ventricular function are present in patients after the Fontan operation and to explore the implications of any such abnormalities for ventricular filling. DESIGN AND PATIENTS: Prospective study in which 25 patients after the Fontan operation were compared with 25 healthy controls and 12 patients with a univentricular atrioventricular connection, before the Fontan operation. INTERVENTIONS: Doppler echocardiography, with simultaneous electrocardiogram, phonocardiogram, and respirometer. RESULTS: Isovolumic relaxation time was significantly longer in patients after the Fontan operation than in normal children (p less than 0.001) or the preoperative patients (p = 0.001). Systolic intraventricular flow was detected in 60% of patients after the Fontan operation and in 42% of preoperative patients. After the Fontan operation 80% of patients showed intraventricular flow during isovolumic relaxation compared with 8% of normal children and none of the preoperative patients. CONCLUSIONS: Incoordinate ventricular relaxation is common after the Fontan operation. This may have important implications for ventricular diastolic filling, pulmonary blood flow, and cardiac output in these patients.
Authors: Lynn A Sleeper; Page Anderson; Daphne T Hsu; Lynn Mahony; Brian W McCrindle; Stephen J Roth; J Phillip Saul; Richard V Williams; Tal Geva; Steven D Colan; Bernard J Clark Journal: Am Heart J Date: 2006-09 Impact factor: 4.749
Authors: M Hauser; F M Bengel; A Kühn; U Sauer; S G Nekolla; A Eicken; M Schwaiger; J Hess Journal: Pediatr Cardiol Date: 2003-01-28 Impact factor: 1.655