LUNG-FUNCTION IN RELATION TO HEMODYNAMIC STATUS AFTER ATRIAL REDIRECTION FOR TRANSPOSITION OF THE GREAT-ARTERIES

To assess the interplay between haemodynamic sequelae and lung functio n after atrial redirection for transposition of the great arteries, we investigated 15 Mustard (age 12.0-22.0 years), and 15 Senning patient s (age 7.2-12.1 years). As diagnosed at cardiac catheterization and ul tracardiography, 16 (11 Mustard) had major haemodynamic sequelae, incl uding systemic ventricle dysfunction, pulmonary hypertension, pulmonar y venous obstruction, systemic venous obstruction and atrial septal de fects. Static and dynamic lung volumes, ventilation distribution and d iffusion capacity were assessed by body plethysmography, spirometry, t he single-breath nitrogen test (N(2)slope) and the single-breath metho d for diffusion capacity (DLCO) respectively. Apart from DLCO, our own reference values were used for comparison. We found small lung volume s, a high functional residual capacity, a high N(2)slope and a low DLC O. Tests of >2SD in the abnormal direction were more prevalent in the Mustard group (P = 0.06) and significantly more prevalent in patients with pulmonary hypertension. Six had normal lung function tests, 15 ha d unclassified abnormalities, three had small lungs and three had cent ral airway obstruction. Peripheral airway obstruction was only present in three of four subjects with moderate or severe pulmonary hypertens ion. The study confirms some previous reports indicating a high freque ncy of lung function abnormalities in these patient groups and discuss es a possible relationship to haemodynamic status.