J. Hruda et al., GOOD EXERCISE TOLERANCE AND IMPAIRED LUNG-FUNCTION AFTER ATRIAL REPAIR OF TRANSPOSITION, European journal of cardio-thoracic surgery, 12(2), 1997, pp. 184-189
Objective: Evaluation of long-term results of atrial correction of tra
nsposition of tile great arteries (TGA). focusing on the relationship
between pulmonary function and exercise tolerance. Methods: A prospect
ive population-based study-56 out of 60 survivors of Mustard/Senning r
epair, born in Bohemia in 1980-1984 (median age at surgery 0.85 years)
were followed up over 13.4 +/- 1.2 years and studied by complete lung
function and bicycle exercise testing. Results: Maximum heart rate on
exercise reached 181 +/- 14 bpm (Z-score: -1.06 +/- 1.66, range -6.7
to +1.6); V-O2max: 40.6 +/- 6.7 ml/kg per min (Z-score: -0.97 +/- 1.4,
range - 5 to + 1.8). A total of 73.6% had abnormal lung function, mos
t frequently features of stiff lung (39.6%) and lung restriction (32.1
%). Static recoil pressure of the lungs measured at 100, 90 and 60% of
total lung capacity reached 137, 126 and 130%, respectively (Z-score:
1.93 +/- 2.33, 1.64 +/- 1.96, and 1.14 +/- 1.95, respectively). There
was an inverse relationship between static recoil pressure of the lun
gs and V-O2max (r = -0.306, P = 0.043), indicating the impact of lung
function abnormalities on exercise tolerance. Comparison with lung fun
ction study of the group of 'pioneer' Mustard patients operated at the
mean age of 4.4 years revealed a similar pattern and frequency (73.6%
in current series vs. 88%, NS). Conclusions: Long-term follow-up has
shown good exercise tolerance in the majority of patients after atrial
correction of TGA performed in infancy. Many of them, however, have i
mpaired lung function, especially stiff lung, although less frequently
than original patients operated at a later age. The stiff lung can im
pair the exercise tolerance. (C) 1997 Elsevier Science B.V.