Wall thickness of ventricular chambers in transposition of the great arteries

Baño-Rodrigo, Antonio; Quero-Jiménez, M; Moreno-Granado, F.; Gamallo-Amat, Carlos

doi:10.1016/s0022-5223(19)37925-5

Cited by 41 publications

(4 citation statements)

References 17 publications

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“…It is well recognized that the heart is capable of remodeling, although this is not always desirable. Bano‐Rodrigo et al (1980) pointed to the need for anatomical correction of complete transposition prior to the regression of the ventricular compact myocardium in the left ventricle, functioning as a low‐pressure pulmonary pump. This is now current practice in neonatal and infant cardiac surgery, where corrective operations are performed as soon as possible (Castaneda et al, 1994).…”

Section: Human Pathologymentioning

confidence: 99%

Developmental patterning of the myocardium

et al. 2000

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The heart in higher vertebrates develops from a simple tube into a complex organ with four chambers specialized for efficient pumping at pressure. During this period, there is a concomitant change in the level of myocardial organization. One important event is the emergence of trabeculations in the luminal layers of the ventricles, a feature which enables the myocardium to increase its mass in the absence of any discrete coronary circulation. In subsequent development, this trabecular layer becomes solidified in its deeper part, thus increasing the compact component of the ventricular myocardium. The remaining layer adjacent to the ventricular lumen retains its trabeculations, with patterns which are both ventricle- and species-specific. During ontogenesis, the compact layer is initially only a few cells thick, but gradually develops a multilayered spiral architecture. A similar process can be charted in the atrial myocardium, where the luminal trabeculations become the pectinate muscles. Their extent then provides the best guide for distinguishing intrinsically the morphologically right from the left atrium. We review the variations of these processes during the development of the human heart and hearts from commonly used laboratory species (chick, mouse, and rat). Comparison with hearts from lower vertebrates is also provided. Despite some variations, such as the final pattern of papillary or pectinate muscles, the hearts observe the same biomechanical rules, and thus share many common points. The functional importance of myocardial organization is demonstrated by lethality of mouse mutants with perturbed myocardial architecture. We conclude that experimental studies uncovering the rules of myocardial assembly are relevant for the full understanding of development of the human heart.

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Section: Human Pathologymentioning

confidence: 99%

Developmental patterning of the myocardium

et al. 2000

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“…It is also well known that the thickness of the left ventricular wall becomes below normal in children with complete transposition and intact ventricular septum (simple transposition) as they grow beyond infancy. 17 ' 19 These facts would suggest that the left coronary artery could be smaller than normal in these children. In studies of postmortem specimens of complete transposition, Oberhoffer et al 20 found that the sizes of the right and left coronary arteries were not different from normal even in infancy and childhood.…”

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confidence: 95%

The size of the coronary arteries in children with complete transposition before and after the arterial switch operation

Yatsunami¹,

Nakazawa²,

Seguchi³

et al. 1994

Cardiol Young

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The size of the coronary arteries parallels the ventricular mass, thus it may be abnormal in complete transposition beyond infancy and could be influenced by the arterial switch operation. To investigate this possibility, we measured the diameters of the right, left main trunk, anterior descending, and circumflex coronary arteries before and three to seven years (mean 4.8) after the arterial switch operation in 17 patients with a “normal” distribution of the coronary arteries (so-called Shaher type 1). The values were compared with 18 controls who had Kawasaki disease with no apparent coronary arterial disease. The right, left anterior descending, and circumflex arteries were smaller than control values before the operation. The post-/preoperative ratios of the diameter were 1.16±0.11 for the right coronary artery, 1.18±0.16 for the left main trunk, 1.20±0.18 for the left anterior descending artery, and 1.22±0.26 for the circumflex artery. There were no significant differences among these values. After surgery, the right coronary artery was larger, but the left coronary arteries were smaller in the patients than in the controls: 2.5±0.3 vs 2.0±0.2 mm for the right coronary artery; 2.4±0.3 vs 2.7±0.1 mm for the left main trunk; 1.9±0.2 vs 2.4±0.2 mm for the left anterior descending artery; 1.6±0.4 vs 2.2±0.5 mm for the circumflex artery, respectively. The posterior descending coronary artery originated from the right coronary artery in all patients. The total cross-sectional area of the right coronary, left anterior descending, and circumflex arteries was 9.7±2.4 mm2in the patients, and 11.8±2.9 mm2in the controls (p>O. 1), suggesting that the increased size of the right coronary artery compensates for the small left coronary arteries. We conclude that the arterial system in complete transposition, with a large right coronary artery and small left coronary system, remains smaller than normal even at midterm follow-up after anatomic repair despite normalization of left ventricular volume and muscle mass.

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“…Slow induction of epidural is advisable [1,4,5]. In this case, the selection for general anesthesia technique was preferred, because of time efficiency and hemodynamic stability should be a priority, since the cesarean section was performed under emergency circumstances general anesthesia becomes the ideal technique [6][7][8][9][10][11][12]. The patient had two risk factors for infectious endocarditis, history of previous endocarditis and high-risk cardiopathy.…”

Section: Discussionmentioning

confidence: 99%