Congenital Heart DiseaseResults of the Bruce Treadmill Test in Children After Arterial Switch Operation for Simple Transposition of the Great Arteries
Section snippets
Patients:
Eligibility criteria for participation in this study included (1) an arterial switch operation in our institution during the neonatal period, (2) age >48 months, (3) no physical limitations (New York Heart Association functional class 1), no symptoms and no cardioactive medications, (4) no prior experience with the treadmill and no opportunity for practice. Fifty patients, aged 4 to 9 years (mean ± SD 5.6 ± 1.5), participated in the study. There were 40 boys and 10 girls. All children were
Results
Forty-seven patients had a normal exercise capacity and normal cardiovascular parameters. The maximal heart rate at peak exercise was 186.9 ± 10.2 beats/min, but >180 beats/min in all cases. Endurance time was >90th percentile in 7 patients, between the 75th and the 90th percentile in 11, between the 50th and the 75th percentile in 14, between the 25th and the 50th percentile in 7, between the 10th and the 25th percentile in 7, and <10th percentile in 1. This last child did not produce a near
Discussion
The mobilization and translocation of the coronary arteries remains the most technically challenging aspect of the arterial switch operation; it carries the combined risk of primary ischemic injury and late problems with coronary artery kinking, stenosis, or occlusion.
Several investigators described late coronary occlusion or stenosis.2, 3, 5, 6, 7, 8Their incidence was 3% of the 366 patients whose cineangiograms had been reviewed by Tanel et al[9]and 7.8% of the 64 patients of Bonnet et al[8]
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