PURPOSE: The aim of this study was to investigate the surgical outcomes and change in cardiac performance after total cavopulmonary connection (TCPC) in patients with reduced ventricular ejection preoperatively. METHODS: Among the 195 patients undergoing TCPC between 1990 and 2001 were 52 who had a preoperative ejection fraction of ≤50% (30%-50%, mean 44%). A dominant ventricle was of the morphologically right type in 81% of patients. RESULTS: A total of 9 of the 52 patients died early. Two patients died in the intermediate term. Postoperative exercise testing showed maximum oxygen uptake of 26.4 ± 5.8 ml/kg/min (anaerobic threshold 18.3 ± 3.2 ml/kg/ min). The cardiac index was 3.1 ± 0.9 l/min/m(2) at 1 year after TCPC, with no fundamental change at 5 years (3.1 ± 0.8 l/min/m(2)). The end-diastolic volume of the dominant ventricle was 130% ± 74% of the anticipated normal value at 1 year and 93% ± 27% at 5 years after TCPC, with ejection fractions of 48% ± 13% and 49% ± 9%, respectively. When these parameters were plotted for the individual patients, the ejection fraction increased during the first postoperative year, with the percent end-diastolic volume decreasing in 31 survivors; the trend appeared atypical in the remaining 12 survivors. Even in these patients, however, the parameters eventually changed toward favorable circumstances 5 years after TCPC. CONCLUSION: Change in ventricular function was not necessarily pessimistic after TCPC in patients with reduced ventricular contraction preoperatively.
PURPOSE: The aim of this study was to investigate the surgical outcomes and change in cardiac performance after total cavopulmonary connection (TCPC) in patients with reduced ventricular ejection preoperatively. METHODS: Among the 195 patients undergoing TCPC between 1990 and 2001 were 52 who had a preoperative ejection fraction of ≤50% (30%-50%, mean 44%). A dominant ventricle was of the morphologically right type in 81% of patients. RESULTS: A total of 9 of the 52 patients died early. Two patients died in the intermediate term. Postoperative exercise testing showed maximum oxygen uptake of 26.4 ± 5.8 ml/kg/min (anaerobic threshold 18.3 ± 3.2 ml/kg/ min). The cardiac index was 3.1 ± 0.9 l/min/m(2) at 1 year after TCPC, with no fundamental change at 5 years (3.1 ± 0.8 l/min/m(2)). The end-diastolic volume of the dominant ventricle was 130% ± 74% of the anticipated normal value at 1 year and 93% ± 27% at 5 years after TCPC, with ejection fractions of 48% ± 13% and 49% ± 9%, respectively. When these parameters were plotted for the individual patients, the ejection fraction increased during the first postoperative year, with the percent end-diastolic volume decreasing in 31 survivors; the trend appeared atypical in the remaining 12 survivors. Even in these patients, however, the parameters eventually changed toward favorable circumstances 5 years after TCPC. CONCLUSION: Change in ventricular function was not necessarily pessimistic after TCPC in patients with reduced ventricular contraction preoperatively.
Authors: D A Harrison; P Liu; J E Walters; J M Goodman; S C Siu; G D Webb; W G Williams; P R McLaughlin Journal: J Am Coll Cardiol Date: 1995-10 Impact factor: 24.094
Authors: H Uemura; T Yagihara; Y Kawashima; F Yamamoto; K Nishigaki; O Matsuki; K Okada; T Kamiya; R H Anderson Journal: J Thorac Cardiovasc Surg Date: 1995-08 Impact factor: 5.209
Authors: H Ohuchi; Y Hiraumi; H Tasato; A Kuwahara; H Chado; K Toyohara; Y Arakaki; T Yagihara; T Kamiya Journal: Am Heart J Date: 1999-06 Impact factor: 4.749
Authors: S Nakata; Y Imai; Y Takanashi; H Kurosawa; K Tezuka; M Nakazawa; M Ando; A Takao Journal: J Thorac Cardiovasc Surg Date: 1984-10 Impact factor: 5.209