Circulation, Vol 65, 1052-1059, Copyright © 1982 by American Heart Association
LN Benson, J Bonet, P McLaughlin, PM Olley, D Feiglin, M Druck, G Trusler, RD Rowe and J Morch
Right ventricular (RV) performance during supine bicycle exercise was
evaluated by gated equilibrium nuclear angiography in 19 clinically well
children with d-transposition of the great arteries (d-TGA), 6.4 +/- 2.7
years after Mustard's operation. Comparisons were made between rest and
peak exercise. The mean resting ejection fraction was 44 +/- 12% (range
30-75%) and was unchanged at peak exercise. Eight children had a normal
ejection fraction response, whereas 11 children had either no increase or a
decrease in ejection fraction. Relative end-diastolic volumes decreased
from resting values in all patients who had an abnormal ejection fraction
response. Among patients whose ejection fraction increased, the
end-diastolic volume increased in three, decreased in four and was
unchanged in one at peak exercise. Heart rate increased 84% (range 52-135%)
and systolic blood pressure increased 16% (range 0-28%) at peak exercise.
There was no correlation between exercise response and age at surgery or
interval since surgery. These data indicate that clinically well children
after Mustard's procedure may have abnormal right ventricular function
under stress, raising concerns about the ability of the right ventricle to
function as the systemic ventricle.
ARTICLES
Assessment of right ventricular function during supine bicycle exercise after Mustard's operation
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