European heart journal
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European heart journal · Sep 1997
The double switch procedure for anatomical repair of congenitally corrected transposition of the great arteries in infants and children.
To assess outcomes of anatomical repair (double switch procedure) in infants and children with congenitally corrected transposition of the great arteries. ⋯ Anatomical repair of corrected transposition can be achieved with low rates of early mortality and surgical heart block, and favourable mid-term results. Long-term follow-up will be necessary to determine if the double switch approach improves the natural history of corrected transposition when compared to less aggressive surgical approaches that leave the right ventricle in the systemic circulation.
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European heart journal · Aug 1997
Dyspnoea and exercise intolerance during cardiopulmonary exercise testing in patients with univentricular heart. The effects of chronic hypoxaemia and Fontan procedure.
Patients with univentricular hearts have decreased exercise tolerance and may demonstrate exertional dyspnoea. It is not known if chronic hypoxaemia exacerbates exercise intolerance and contributes to symptomatic limitation. The extent to which surgical correction of a right-to-left shunt by a Fontan-type procedure can increase exercise tolerance by reducing arterial deoxygenation is not well documented. The cardiopulmonary exercise responses and the symptomatic status in two groups of univentricular patients, those who are cyanotic and those who are acyanotic with Fontan-type circulation, were compared. ⋯ Despite correction with Fontan-type surgery, the exercise tolerance and symptoms of these univentricular patients remained similar to those who were cyanosed. Cyanotic patients have adjusted to chronic hypoxaemia and it does not appear to determine the exercise tolerance or the genesis of dyspnoea in these patients. Further randomized prospective studies are required to investigate the long-term benefits of Fontan-type procedures in these patients on exercise tolerance, symptoms and prognosis.
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European heart journal · Aug 1997
Vectorcardiographic monitoring of patients with acute myocardial infarction and chronic bundle branch block.
This study was set up to describe vectorcardiographic patterns in patients with bundle-branch block and acute myocardial infarction. ⋯ Our results indicate that dynamic vectorcardiography is a valuable tool in diagnosing and monitoring acute myocardial infarction in patients with bundle branch block.
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European heart journal · Jul 1997
The apical long-axis rather than the two-chamber view should be used in combination with the four-chamber view for accurate assessment of left ventricular volumes and function.
Most biplane methods for the echocardiographic calculation of left ventricular volumes assume orthogonality between paired views from the apical window. Our aim was to study the accuracy of biplane left ventricular volume calculations when either the apical two-chamber or long-axis views are combined with the four-chamber view. The left ventricular volumes calculated from three-dimensional echocardiographic data sets were used as a reference. Twenty-seven patients underwent precordial three-dimensional echocardiography using rotational acquisition of planes at 2-degree intervals, with ECG and respiratory gating. End-diastolic and end-systolic left ventricular volumes and ejection fraction on three-dimensional echocardiography were calculated by (1) Simpson's methods (3DS) at 3 mm short-axis slice thickness (reference method) and by (2) biplane ellipse from paired views using either apical four- and two-chamber views (BE-A) or apical four- and long-axis views (BE-B). Observer variabilities were studied by the standard error of the estimate % (SEE) in 19 patients for all methods. ⋯ Both apical two-chamber and apical long-axis views are not orthogonal to the apical four-chamber view. Observer variabilities of BE-B were smaller than that for BE-A. BE-A and BE-B have excellent correlation and non-significant differences with 3DS for left ventricular volume and ejection fraction calculations. There were closer limits of agreement between BE-B with 3DS for left ventricular volume and ejection fraction calculations than that between BE-A and 3DS. Therefore, we recommend the use of the apical long-axis rather than the two-chamber view in combination with the four-chamber view for accurate biplane left ventricular volume and ejection fraction calculations.