Left ventricular function and compliance in pulmonary atresia with intact ventricular septum
Sideris, E.B.; Olley, P.M.; Spooner, E.; Farina, M.; Foster, E.; Trusler, G.; Shaher, R.
Journal of Thoracic and Cardiovascular Surgery 84(2): 192-199
1982
ISSN/ISBN: 0022-5223 PMID: 7098506 Document Number: 193393
Left ventricular systolic function and compliance were assessed in 15 cases of pulmonary atresia with intact ventricular septum. The left ventricular ejection fraction measured from cineangiography was used for the evaluation of the systolic function. The end-diastolic pressure (EDP), left ventricular compliance index at end-diastole (dv/dp ), and left ventricular stiffness constant K were used as compliance indices. The mean left ventricular ejection fraction was slightly diminished. The right ventricular end diastolic pressures (RVEDP) correlated significantly (r = 0.90) with the left ventricular end diastolic pressure (LVEDP). On the basis of left ventricular compliance, 2 distinctive groups of patients were identified: group 1 consisted of patients 1 to 7, all with impaired left ventricular compliance. A shunt operation was the basic palliation in this group. None of these patients survived infancy. Group 2 consisted of patients 8 to 15, all with normal left ventricular compliance. Pulmonary valvotomy as well as aortopulmonary shunts were the basic palliative procedures in this group. Six of 8 patients in this group are long-term survivors. No difference was found in right ventricular size, tricuspid valve size, presence of tricuspid insufficiency, presence of a patent ductus arteriosus, postoperative O2 saturations and atrial pressure gradients between the 2 groups. Evaluation of the left ventricular compliance in patients with pulmonary atresia and intact ventricular septum might be of significant prognostic value for their early survival.