Skip to main content
PMC home page
British Heart Journal logoLink to British Heart Journal
. 1991 Dec;66(6):456–459. doi: 10.1136/hrt.66.6.456

Angiographic demonstration of incoordinate motion of the ventricular wall after the Fontan operation.

D J Penny 1, A N Redington 1
PMCID: PMC1024822  PMID: 1772713

Abstract

OBJECTIVE--To study regional wall motion of the systemic ventricle in patients after the Fontan operation. DESIGN AND PATIENTS--Systemic ventricular angiograms of 15 patients after the Fontan operation and of 11 unoperated patients with a univentricular atrioventricular connection were digitised frame by frame. Strict criteria for abnormal wall motion were used so that minor abnormalities were not considered. RESULTS--Incoordinate contraction of the ventricular wall was found in five of the 11 patients before and in four of the 15 patients after the Fontan operation (NS). Only three of the 11 patients before the Fontan operation, showed incoordination of ventricular relaxation, but incoordinate relaxation was seen in 12 of the 15 patients after operation (p less than 0.01). CONCLUSIONS--Whereas incoordination of ventricular contraction was common in patients with a univentricular atrioventricular connection, before or after the Fontan operation, incoordinate relaxation of the ventricular wall was a common consequence of the Fontan operation and was rare in patients before operation.

Full text

PDF
456

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aoyagi T., Iizuka M., Takahashi T., Ohya T., Serizawa T., Momomura S., Sato H., Mochizuki T., Matsui H., Ikenouchi H. Wall motion asynchrony prolongs time constant of left ventricular relaxation. Am J Physiol. 1989 Sep;257(3 Pt 2):H883–H890. doi: 10.1152/ajpheart.1989.257.3.H883. [DOI] [PubMed] [Google Scholar]
  2. Di Donato M., Barletta G., Mori F., Fantini F. Regional left ventricular wall motion abnormalities in chronic volume overload. Cathet Cardiovasc Diagn. 1983;9(5):453–462. doi: 10.1002/ccd.1810090504. [DOI] [PubMed] [Google Scholar]
  3. Fontan F., Baudet E. Surgical repair of tricuspid atresia. Thorax. 1971 May;26(3):240–248. doi: 10.1136/thx.26.3.240. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Garrahy P. J., Kwan O. L., Booth D. C., DeMaria A. N. Assessment of abnormal systolic intraventricular flow patterns by Doppler imaging in patients with left ventricular dyssynergy. Circulation. 1990 Jul;82(1):95–104. doi: 10.1161/01.cir.82.1.95. [DOI] [PubMed] [Google Scholar]
  5. Gibson D. G., Prewitt T. A., Brown D. J. Analysis of left ventricular wall movement during isovolumic relaxation and its relation to coronary artery disease. Br Heart J. 1976 Oct;38(10):1010–1019. doi: 10.1136/hrt.38.10.1010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Gibson D. G., Traill T. A., Brown D. J. Abnormal ventricular function in patients with univentricular heart. Cineangiographic study. Herz. 1979 Apr;4(2):226–231. [PubMed] [Google Scholar]
  7. Hagler D. J., Seward J. B., Tajik A. J., Ritter D. G. Functional assessment of the Fontan operation: combined M-mode, two-dimensional and Doppler echocardiographic studies. J Am Coll Cardiol. 1984 Oct;4(4):756–764. doi: 10.1016/s0735-1097(84)80403-9. [DOI] [PubMed] [Google Scholar]
  8. Hall R. J., Doran J., Pusey C., McHaffie D., Gibson D. G. The effect of nitroglycerin, beta-blockade with acebutolol and isometric stress on incoordinate left ventricular function. Eur Heart J. 1982 Feb;3(1):23–28. doi: 10.1093/oxfordjournals.eurheartj.a061257. [DOI] [PubMed] [Google Scholar]
  9. Heusch G. Alpha-adrenergic mechanisms in myocardial ischemia. Circulation. 1990 Jan;81(1):1–13. doi: 10.1161/01.cir.81.1.1. [DOI] [PubMed] [Google Scholar]
  10. Ludbrook P. A., Byrne J. D., Tiefenbrunn A. J. Association of asynchronous protodiastolic segmental wall motion with impaired left ventricular relaxation. Circulation. 1981 Dec;64(6):1201–1211. doi: 10.1161/01.cir.64.6.1201. [DOI] [PubMed] [Google Scholar]
  11. Penny D. J., Rigby M. L., Redington A. N. Abnormal patterns of intraventricular flow and diastolic filling after the Fontan operation: evidence for incoordinate ventricular wall motion. Br Heart J. 1991 Nov;66(5):375–378. doi: 10.1136/hrt.66.5.375. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Perrone-Filardi P., Betocchi S., Giustino G., Piscione F., Indolfi C., Salvatore M., Chiariello M. Influence of left ventricular asynchrony on filling in coronary artery disease. Am J Cardiol. 1988 Sep 15;62(9):523–527. doi: 10.1016/0002-9149(88)90648-0. [DOI] [PubMed] [Google Scholar]
  13. Sasson Z., Hatle L., Appleton C. P., Jewett M., Alderman E. L., Popp R. L. Intraventricular flow during isovolumic relaxation: description and characterization by Doppler echocardiography. J Am Coll Cardiol. 1987 Sep;10(3):539–546. doi: 10.1016/s0735-1097(87)80196-1. [DOI] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES