Circulation, Vol 58, 1083-1093, Copyright © 1978 by American Heart Association
NH Silverman, M Payot, P Stanger and AM Rudolph
In order to establish an echocardiographic profile of patients with simple
transposition after Mustard's operation, we examined the M-mode records of
10 patients who were found to be free of significant abnormalities at
follow-up cardiac catheterization. When compared with established normals,
right ventricular wall thicknesses and cavity dimensions were increased,
while left ventricular wall thicknesses and cavity dimensions fell below
the mean. The wall thicknesses, cavity dimensions and ratios of right
ventricular preejection period/ejection time and left ventricular
preejection period/ejection time were appropriate for the physiologic role
of the ventricles rather than their morphologic identity. In each patient,
a portion of the intra- atrial baffle was identified behind the pulmonary
root. There was variation in baffle position and baffle mobility within the
group, as well as in individual echograms. A variety of valve motion
abnormalities were noted; these included diastolic flutter of the
atrioventricular valves in all 10 patients and systolic anterior motion of
the mitral valve in six patients. Paradoxical septal motion was found in
nine patients. Although only minimal or no left ventricular outflow
gradients were found at catheterization, nine patients had narrowing of the
left ventricular outflow tract, 10 had systolic flutter of the pulmonary
valve and eight had early partial closure of the pulmonary valve. The
finding of a large number of echocardiographic abnormalities in a group of
patients with good hemodynamic results suggests that these
echocardiographic features are to be expected after Mustard's opration.
Furthermore, the reversal of the physiologic role of the ventricles must be
considered when interpreting the echocardiographic dimensions and systolic
time intervals.
ARTICLES
The echocardiographic profile of patients after Mustard's operation