J.Jpn. Surg. Soc.. 83(6): 524-533, 1982
Original article
VENTRICULAR VOLUME CHARACTERISTICS OF SINGLE VENTRICLE BEFORE AND AFTER CORRECTIVE SURGERY
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First Department of Surgery, Osaka University Medical School Yasuhisa Shimazaki, M.D., Hajime Hirose, M.D., Susumu Nakano, M.D., Hikaru Matsuda, M.D., Shizuo Morimoto, M.D.*), Jun Arisawa, M.D.*), Minoru Ogawa, M.D.**), Soichiro Kitamura, M.D., Tohru Mori, M.D., Yasunaru Kawashima, M.D. |
In 20 patients prior to corrective surgery, ventricular end-diastolic volume of single ventricle ranged from 64 to 206 (115±42)% of the sum of the normal left and right ventricular volumes (mean±SDM). Ejection fraction of single ventricle ranged from 0.40 to 0.64 (0.55±0.06). There was a high correlation of ventricular end-diastolic volume with pulmonary to systemic flow ratios (r=0.66, p＜0.005). Atrioventricular valvular regurgitation was evident in 6 patients with common atrioventricular valve. Ejection fraction in patients with atrioventricular valvular regurgitation was significantly lower (0.49) than that in those without incompetence (0.57) (p＜0.01).
In 2 patients after total correction, total ventricular volume was 136 and 166% of the sum of the normal left and right ventricular volumes, respectively. Total ejection fraction was 0.55 and 0.38, respectively. The right to left ventricular volume ratio at end-diastole was 0.74 in the first and 0.56 in the second patient.
These results indicate that 1) larger ventricular volume than the sum of the normal left and right ventricular volumes was required for ventricular septation of the single ventricle, 2) systemic to pulmonary shunt should be effective to enlarge the ventricular volume of the single ventricle, 3) single ventricle should be divided into two to make a large left and a small right ventricular volume, when the right ventricular peak pressure was lower than the left after total correction.
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