[Echocardiographic pressure-dimension analysis following anatomically corrective operation of d-transposition of the...

The major theoretical advantage of anatomic correction of transposition of the great arteries compared with intraatrial repair is that the left ventricle becomes the systemic pump. In 10 patients we analysed 5-12 months after anatomic correction the left ventricular echocardiographic pressure-dimension loop, meridional wall stress and left ventricular stiffness from the simultaneous recordings of the left ventricular pressure and M-mode echocardiogram. The low left ventricular diameters, left ventricular hypertrophy in 4 patients, and increased peak meridional wall stress in 3 patients indicate that left ventricular adaption to systemic impedance is still incomplete 5-12 months after anatomic correction. The cycle efficiency was reduced in 2 patients, indicating incoordinate left ventricular contraction and relaxation. In one of these patients the left ventricular stiffness was severely increased, while in another patient there was a slight increase in left ventricular stiffness. In all patients the right ventricular internal diameter was increased due to the long-standing preoperative pressure and volume overload.