Circulation, Vol 55, 361-370, Copyright © 1977 by American Heart Association
R Mathew, OG Thilenius, RL Replogle and RA Arcilla
Cardiac performance was evaluated in 12 infants with isolated total
anomalous pulmonary venous return. Four had significant pulmonary venous
obstruction and severe pulmonary hypertension (group A). Eight had no
obvious venous obstruction, and the pulmonary pressures were lower (group
B). In all subjects, right ventricular end-diastolic volume was increased
(197% of predicted normal) and its ejection fraction was normal. Left
ventricular volume was, generally speaking, still in the normal range (87%
of predicted normal); however, its ejection fraction was reduced (0.57 vs
normal of 0.73) and left ventricular output was low (3.08 L/min/m2 vs
normal of 3.98). Left atrial volume was consistently small (53% of
predicted normal) with an appendage of normal size. The infants in group A
had smaller chamber volumes/m2 BSA than those in group B. Left atrial
function was abnormal, characterized by reduced reservoir function and a
greater role as "conduit" from right atrium to left ventricle. Left atrial
size was not found to be critical in the surgical repair of TAPVR. Cardiac
function is restored to normal following surgery.
ARTICLES
Cardiac function in total anomalous pulmonary venous return before and after surgery
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