Cardiovascular response to exercise after the mustard operation for simple and complex transposition of the great vessels

https://doi.org/10.1016/0002-9149(88)90666-2Get rights and content

Abstract

After the Mustard operation, patients have reduced exercise tolerance, abnormal right and left ventricular responses to exercise and cardiac rhythm disturbances. The cardiovascular response to exercise was measured noninvasively in 19 patients from 4.5 to 20 years (mean 10.3) after operation. Mean work performed and maximal oxygen uptake for the group were substantially subnormal (42 ± 23% and 59 ± 18% [mean ± 1 standard deviation] of the predicted values, respectively). Resting heart rate, blood pressure, systemic arterial blood oxygen saturation, cardiac index, stroke volume and systemic vascular resistance were not significantly different from control values. At maximal exercise, heart rate, systemic arterial blood oxygen saturation, cardiac index and stroke volume were significantly reduced in comparison with control values. After the Mustard operation, cardiovascular status at rest may be relatively normal, but during maximal exercise, marked abnormalities occur in nearly all indexes of cardiovascular function. Decreased cardiac output response to exercise is a result of decreased stroke volume response and, to a lesser extent, diminished heart rate. It is associated with abnormally increased total systemic vascular resistance.

References (17)

There are more references available in the full text version of this article.

Cited by (60)

  • Anesthesia for Noncardiac Surgery in Children With Congenital Heart Disease

    2019, A Practice of Anesthesia for Infants and Children
  • Anesthesia for Noncardiac Surgery in Children With Congenital Heart Disease

    2018, A Practice of Anesthesia for Infants and Children
  • Stress Echocardiographic Evaluation for D-Transposition of the Great Arteries after Atrial Redirection: Unmasking Early Signs of Myocardial Dysfunction and Baffle Stenosis

    2017, Journal of the American Society of Echocardiography
    Citation Excerpt :

    SSCE showed increased baffle Doppler velocity, unmasking SVC obstruction. Using treadmill or supine cycle ergometry, previous studies have reported decreased exercise capacity and HR response in these patients.15-21 The advantage of SSCE is that it enables echocardiographic and hemodynamic measurements to be performed during exercise and thus provides comprehensive and objective evaluation of cardiac function under physiologic conditions.33,39

  • Anesthesia for Noncardiac Surgery in Children with Congenital Heart Disease

    2009, A Practice of Anesthesia for Infants and Children
  • Anesthesia for noncardiac surgery in children with congenital heart disease

    2008, A Practice of Anesthesia for Infants and Children: Expert Consult
  • Chronotropic Incompetence in Adolescents and Adults With Congenital Heart Disease After Cardiac Surgery

    2007, Journal of Cardiac Failure
    Citation Excerpt :

    Patients with surgically corrected LRS have the lowest risk for CI. Odds ratio (Table 4) for CI in patients with CoA and patients with pulmonary or aortic valve replacement indicate that CI is not a specific problem in patients after extensive atrial surgery, well known in patients after atrial diversion procedure.23–28 It has been shown that CI may be due to postsynaptic desensitization of the β-adrenergic receptor pathway during CHF29 and may be related to abnormalities in autonomic regulation.30

View all citing articles on Scopus
View full text