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Cardiopulmonary exercise performance in adult survivors of the Mustard procedure

Published online by Cambridge University Press:  15 August 2006

S. J. Hechter
Affiliation:
Congenital Cardiac Centre for Adults, The Toronto General Hospital, Toronto, Ontario, Canada
G. Webb
Affiliation:
Congenital Cardiac Centre for Adults, The Toronto General Hospital, Toronto, Ontario, Canada
P. M. Fredriksen
Affiliation:
Congenital Cardiac Centre for Adults, The Toronto General Hospital, Toronto, Ontario, Canada
L. Benson
Affiliation:
Department of Cardiology, The Hospital for Sick Children, Toronto, Ontario, Canada
N. Merchant
Affiliation:
Department of Medical Imaging, Toronto General Hospital, Toronto, Ontario, Canada
M. Freeman
Affiliation:
Congenital Cardiac Centre for Adults, The Toronto General Hospital, Toronto, Ontario, Canada
G. Veldtman
Affiliation:
Congenital Cardiac Centre for Adults, The Toronto General Hospital, Toronto, Ontario, Canada
M. A. Warsi
Affiliation:
Congenital Cardiac Centre for Adults, The Toronto General Hospital, Toronto, Ontario, Canada
S. Siu
Affiliation:
Congenital Cardiac Centre for Adults, The Toronto General Hospital, Toronto, Ontario, Canada
P. Liu
Affiliation:
Heart and Stroke/Richard Lewar Centre of Excellence, University of Toronto, Toronto, Ontario, Canada

Abstract

Most patients with the Mustard procedure are now adults. To date, however, there have been few reports on resting and exercise hemodynamics in a large population of adults with this circulation. The aim of this study is to describe such parameters in one of the largest and oldest populations of adults with the Mustard procedure. The database of the University of Toronto Congenital Cardiac Centre for Adults was examined to identify 84 adults with the Mustard procedure who have undergone cardiopulmonary exercise tests. Magnetic resonance imaging and echocardiography studies were obtained in order to assess right ventricular size, function and baseline hemodynamics. Patients achieved lower maximum uptake of oxygen, maximal heart rate, forced vital capacity, forced expiratory volume in 1 second, and oxygen saturations at maximal exercise compared to a healthy population. Magnetic resonance imaging showed significantly different right ventricular ejection fractions between patients and controls. There were no effects of operative variables or preoperative hemodynamics on current exercise capacity. Patients after the Mustard procedure have subnormal exercise capacities. Factors such as chronotropic incompetence, peripheral deconditioning, and impaired lung function may be responsible for these results.

Type
Original Article
Copyright
2001 Cambridge University Press

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