Abstract
To clarify differences between pre- and postoperative volumetric and hemodynamic variables from patients with clinically good and poor outcomes after a Fontan procedure, 40 patients with univentricular heart (double inlet left ventricle) (mean age: 5.7 ± 3.3 years) were studied using the ventricular cineangiography. According to postoperative clinical findings, patients were classified into two groups: 26 patients with good outcomes and 14 patients with poor outcomes (including five with early and two with intermediate deaths) and compared with a control population. Age at surgery, pre-operative cardiac index, wall mass and systolic ejection phase parameters were not different between the two patient groups, however, end-diastolic volume index in poor outcomes was significantly smaller than those with good outcomes (100 ± 24, 78 ± 22, 64 ± 14 ml/m2: good, poor outcomes and controls, respectively, p <0.05), and the mass/volume ratio in this group significantly elevated (1.00 ± 0.18, 1.19 ± 0.33, 0.97 ± 0.19 g/ml, p <0.05). Postoperatively, both ventricular volume and mass in good outcomes returned toward the normal and the mass/volume ratio remained within normal range (1.07 ± 0.22). In contrast, the hypertrophied ventricular mass in those patients with poor outcomes did not decrease in parallel with ventricular volume, thus contributing to a further increased ratio (1.48 ± 0.19). Although there were no significant differences between pre-operative hemodynamic variables among the two groups, the mass/volume ratio in those with poor outcomes was increased pre-operatively and further increased after the Fontan procedure due to rapid and acute reduction of preload. The unbalanced mass/volume ratio reflecting inappropriate hypertrophy in this setting seemingly contributes to the poor prognosis due to diastolic filling abnormalities.
| Original language | English |
|---|---|
| Pages (from-to) | 220-227 |
| Number of pages | 8 |
| Journal | Herz |
| Volume | 17 |
| Issue number | 4 |
| Publication status | Published - 1992 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
The relationship between ventricular hypertrophy and clinical outcome in patients with double inlet left ventricle after atrial to pulmonary anastomosis. / Akagi, Teiji; Benson, L. N.; Williams, W. G.; Freedom, R. M.
In: Herz, Vol. 17, No. 4, 1992, p. 220-227.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The relationship between ventricular hypertrophy and clinical outcome in patients with double inlet left ventricle after atrial to pulmonary anastomosis
AU - Akagi, Teiji
AU - Benson, L. N.
AU - Williams, W. G.
AU - Freedom, R. M.
PY - 1992
Y1 - 1992
N2 - To clarify differences between pre- and postoperative volumetric and hemodynamic variables from patients with clinically good and poor outcomes after a Fontan procedure, 40 patients with univentricular heart (double inlet left ventricle) (mean age: 5.7 ± 3.3 years) were studied using the ventricular cineangiography. According to postoperative clinical findings, patients were classified into two groups: 26 patients with good outcomes and 14 patients with poor outcomes (including five with early and two with intermediate deaths) and compared with a control population. Age at surgery, pre-operative cardiac index, wall mass and systolic ejection phase parameters were not different between the two patient groups, however, end-diastolic volume index in poor outcomes was significantly smaller than those with good outcomes (100 ± 24, 78 ± 22, 64 ± 14 ml/m2: good, poor outcomes and controls, respectively, p <0.05), and the mass/volume ratio in this group significantly elevated (1.00 ± 0.18, 1.19 ± 0.33, 0.97 ± 0.19 g/ml, p <0.05). Postoperatively, both ventricular volume and mass in good outcomes returned toward the normal and the mass/volume ratio remained within normal range (1.07 ± 0.22). In contrast, the hypertrophied ventricular mass in those patients with poor outcomes did not decrease in parallel with ventricular volume, thus contributing to a further increased ratio (1.48 ± 0.19). Although there were no significant differences between pre-operative hemodynamic variables among the two groups, the mass/volume ratio in those with poor outcomes was increased pre-operatively and further increased after the Fontan procedure due to rapid and acute reduction of preload. The unbalanced mass/volume ratio reflecting inappropriate hypertrophy in this setting seemingly contributes to the poor prognosis due to diastolic filling abnormalities.
AB - To clarify differences between pre- and postoperative volumetric and hemodynamic variables from patients with clinically good and poor outcomes after a Fontan procedure, 40 patients with univentricular heart (double inlet left ventricle) (mean age: 5.7 ± 3.3 years) were studied using the ventricular cineangiography. According to postoperative clinical findings, patients were classified into two groups: 26 patients with good outcomes and 14 patients with poor outcomes (including five with early and two with intermediate deaths) and compared with a control population. Age at surgery, pre-operative cardiac index, wall mass and systolic ejection phase parameters were not different between the two patient groups, however, end-diastolic volume index in poor outcomes was significantly smaller than those with good outcomes (100 ± 24, 78 ± 22, 64 ± 14 ml/m2: good, poor outcomes and controls, respectively, p <0.05), and the mass/volume ratio in this group significantly elevated (1.00 ± 0.18, 1.19 ± 0.33, 0.97 ± 0.19 g/ml, p <0.05). Postoperatively, both ventricular volume and mass in good outcomes returned toward the normal and the mass/volume ratio remained within normal range (1.07 ± 0.22). In contrast, the hypertrophied ventricular mass in those patients with poor outcomes did not decrease in parallel with ventricular volume, thus contributing to a further increased ratio (1.48 ± 0.19). Although there were no significant differences between pre-operative hemodynamic variables among the two groups, the mass/volume ratio in those with poor outcomes was increased pre-operatively and further increased after the Fontan procedure due to rapid and acute reduction of preload. The unbalanced mass/volume ratio reflecting inappropriate hypertrophy in this setting seemingly contributes to the poor prognosis due to diastolic filling abnormalities.
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M3 - Article
VL - 17
SP - 220
EP - 227
JO - Herz
JF - Herz
SN - 0340-9937
IS - 4
ER -