Cardiological and general health status in preschool- and school-age children after neonatal arterial switch operation
| Autor: | Hedwig H. Hövels-Gürich, Bruno J. Messmer, S Däbritz, Marie-Christine Seghaye, G von Bernuth |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
Heart Septal Defects
Ventricular Male Reoperation Pulmonary and Respiratory Medicine medicine.medical_specialty Time Factors Health Status Transposition of Great Vessels Pulmonary insufficiency Ventricular tachycardia Electrocardiography medicine.artery Internal medicine Humans Medicine cardiovascular diseases Myocardial infarction Child medicine.diagnostic_test business.industry Infant Newborn General Medicine Transposition of the great vessels medicine.disease Surgery Stenosis Treatment Outcome Great arteries Child Preschool Pulmonary artery cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | European Journal of Cardio-Thoracic Surgery. 12:593-601 |
| ISSN: | 1010-7940 |
| DOI: | 10.1016/s1010-7940(97)00232-7 |
| Popis: | Objective: Cardiological and general health status 3‐9 years after neonatal arterial switch operation for transposition of the great arteries should be evaluated by non-invasive methods. Methods: A total of 77 unselected children with intact ventricular septum (75.3%) or ventricular septal defect (24.7%) without or with aortic isthmic stenosis (5.2%) were prospectively examined 3.2‐9.4 years (5.491.6) after neonatal switch. Clinical pediatric and cardiological examination, standard and 24 h Holter electrocardiogram, M-mode, 2D-, Doppler and colour Doppler echocardiography were performed. Outcome data were compared to published normals. Results: Reoperation rate was 2.6%, 96.1% were without limitation of physical activity and 98.7% without medication. Compared to normals, growth was adequate, weight and head circumference were slightly reduced. After median sternotomy, 23.4% had abnormal thoracic configuration (16.9% asymmetry, 6.5% funnel chest). ECG and Holter: 93.5% were in sinus, 6.5% in ectopic atrial or junctional rhythm. Incidence of complete right bundle branch block was 15.8% in patients with ventricular septal defect and 5.2% in those without. Ischemic ST-T changes during exercise due to coronary artery occlusion and evidence of old myocardial infarction were found in 1 patient (1.3%) each. Occasional atrial ectopy was found in 27.4%, ventricular ectopy in 15.3%: occasional in 12.5% and frequent (\ 30:h) in 2.8% presenting bigemini, couplets and short runs of ventricular tachycardia at rest and during exercise. Echocardiography: Left ventricular function was normal in all. Endsystolic diameter of neoaortic valve annulus was beyond 90% confidence interval for controls in 79.2%, neoaortic root diameter in 100%. Mild aortic insufficiency was seen in 10.4%. No correlation was found between aortic insufficiency and aortic dilatation. Neoaortic stenosis was not seen, mild residual coarctation after end-to-end-anastomosis was found in 2.6%, native coarctation corrected later on in 1.3%. Supravalvular pulmonary stenosis was seen in 29.9% (19.5% trivial, 7.8% mild, 2.6% moderate), mild subvalvular pulmonary stenosis in 1.3%, pulmonary insufficiency in 2.6%. Conclusion: The study confirms good midterm results after neonatal arterial switch operation for transposition with or without ventricular septal defect. Long-term observation is necessary to assess rhythm, coronary artery and myocardial function as well as development of neo-aorta and pulmonary artery system. © 1997 Elsevier Science B.V. |
| Databáze: | OpenAIRE |
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