PURPOSE: Cardiopulmonary condition and quality of life of patients long-term after successful Mustard or Senning correction for simple transposition of the great arteries (TGA) is influenced by disturbed lung function (1,2). An arterial switch operation (SWT) performed in TGA patients during first three weeks of life should be more beneficial for those patients. Study on pulmonary function (PFT) using a wide spectrum of methods long-term after SWT is lacking.
METHODS: Fifty eight patients with TGA were operated on by SWT operation at the age of 24.4±51.8 (median 10.0) days; small VSD was closed simultaneously in 15/58, 26% patients. Static lung volumes (by body plethysmography), lung elasticity (in 16/58, 28% pts by oesophageal baloon technique) and airway patency measurements (by body plethysmography and flow-volume curves) were performed at the age of 9.7±2.0 (median 9.7) years after SWT.
RESULTS: Total lung capacity (TLC) as well as VC were normal: 101.6±24.2 and 93.2±15.9, respectively (mean value of % predicted±SD). An index of static lung hyperinflation mildly increased (residual volume to TLC was 108.2±30.3 % predicted, P<0.04). Lung recoil at 100% TLC increased (128.0±36.7 % predicted, P<0.002) in accordance with a lowered specific lung compliance (83.1±23.4, P<0.01). Decreased peak expiratory flow rate showed only a mild central airway obstruction (91.0±15.5, P<0.04). No peripheral airway obstruction was found (maximum expiratory flow at 25% VC/TLC was 98.2±31.4, N.S.).
CONCLUSION: Neither lung volume restriction nor peripheral airway obstruction was found long-term after successful SWT operation for TGA. Only mild central airway obstruction, mild lung hyperinflation and mild signs of stiff lungs were detected.
CLINICAL IMPLICATIONS: The current approach of surgical treatment of TGA is beneficial for long-term lung function in those patients. References: 1.Samanek M et al: Int. J Cardiol 1989; 24:13–172; Giljam T et al: Eur Heart J 1995; 16:1952–1959.
DISCLOSURE: Jan Sulc, No Financial Disclosure Information; No Product/Research Disclosure Information