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European Heart Journal 1987 8(3):291-296;
Copyright © 1987 by the European Society of Cardiology.
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© 1987 The European Society of Cardiology

Effects of persiting myocardial sinusoids on left ventricular performance in pulmonary atresia with intact ventricular septum

G. HAUSDORF, L. GRÄVINGHOFF and E. W. KECK

University of Hamburg, Department of Pediatric Cardiology Hamburg, F. R. G.

Received 14 July 1986; .

Address for correspondence: G. Hausdorf, Univcriitatsklinik Hamburg-Eppendorf, Kindcrkardiologic, Martinistr. 52, D-2000 Hamburg 20, F.R.G.

Abstract

The effects of persisting right ventricular myocardial sinusoids on left ventricular global and regional function were studied in 13 patients with pulmonary atresia and intact ventricular septum. Persisting myocardial sinusoids allow the inflow of under saturated blood into the coronary circulation with subsequent myocardial ischaemia. 7 patients had myocardial sinusoids (group 1). 6 patients had normal coronary perfusion (group 2) The measures of global left ventricular function (ejection fraction, left ventricular enddiastolic volume, left ventricular enddiastolic pressure and shape index) showed no differences between the groups. All patients in group 1 showed disturbances of regional wall motion (P≤0005). There was a high degree of coincidence between the disturbances of regional wall motion and the topography of myocardial perfusion from persisting myocardial sinusoids. In group 1 apical hypokinesia was a regular finding, reflected by a significantly reduced shortening of the left ventricular long axis (P ≤ 0.01). As all of these patients had communications between the myocardial sinusoids and the left anterior descending coronary artery, this probably resulted from apical left ventricular ischaemia.

Key Words: Myocardial ischaemia • pulmonary artresia


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