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Anatomical correction for complete transposition and double outlet right ventricle: intermediate assessment of functional results.
  1. C Lincoln,
  2. A N Redington,
  3. K Li,
  4. S Mattos,
  5. E A Shinebourne,
  6. M L Rigby

    Abstract

    Thirty three patients were followed up after anatomical correction of transposition of the great arteries or double outlet right ventricle and subpulmonary ventricular septal defect (Taussig-Bing anomaly). There were no late deaths and clinical progress was excellent. Cardiac catheterisation was performed in 17 patients two weeks to 44 months after operation. There were six patients with simple transposition, six with complete transposition and large ventricular septal defect, and five with the Taussig-Bing anomaly. Pressure gradients across the right ventricular outflow tract ranged from 5 to 72 mm Hg, being greater than 40 mm Hg in five patients. No patient was shown to have important valvar regurgitation and in 15 patients the coronary anastomoses were widely patent. Left ventricular function was assessed from digitised ventriculograms. Ventricular volume, shape, and ejection fraction were all normal for the group although patients with complex transposition showed a significantly lower mean (SD) ejection fraction than those with simple transposition (62(9) vs 77(9]. Analysis of regional wall motion showed a totally normal pattern in four patients; however, in seven patients a characteristic abnormality of anterior hypokinesis with delayed onset of inward wall motion was seen. Anatomical correction of transposition of the great arteries and the Taussig-Bing anomaly can be performed with satisfactory anatomical and functional results. The implications of the left ventricular wall motion abnormalities is unknown.

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