THE HAeMODYNAMICS OF COMPLETE TRANSPOSITION OF THE GREAT VESSELS

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Abstract
The hemodynamics of 37 patients with complete transposition of the great vessels were studied 26 patients were collected from the published reports, and the remaining 11 patients were seen at Guy''s Hospital and at Southampton Chest Hospital. Although the shunt was small in each and averaged 1.62 1./min./m.2, the actual pulmonary and systemic blood flows varied within a much wider range. An inverse relation exists between the pulmonary and the systemic blood flows in cases with a large ventricular septal defect. Patients with a low pulmonary blood flow, or who have small associated defects, develop a hyperkinetic systemic circulation. It is suggested that the mechanism of the exchange of blood in complete transposition of the great vessels is initiated by gradients between the mean atrial pressures and probably also the diastolic ventricular pressures, created by the rate of blood flow in the two circuits. The amount of blood gained by one circuit in this way is likely to be returned to the original circuit during ventricular systole.