A case series of systemic right ventricular dysfunction post atrial switch for simple D-transposition of the great arteries: The impact of beta-blockade

Abstract

Beta-blockade was used infrequently in patients with a prior Mustard procedure. When beta-blockade was prescribed to patients with a prior atrial switch procedure, the drugs were well tolerated and were associated with trends toward improved symptoms, less tricuspid regurgitation and improved functional status in patients with reduced systemic RV function. These data support the need for a randomized trial of beta-blockade in patients with a previous Mustard or Senning operation and RV dysfunction.

Effect of angiotensin receptor blockade on systemic right ventricular function and size: A small, randomized, placebo-controlled study

“…Recent retrospective nonrandomized studies on the effects of beta blockers and systemic right ventricles [30,31] show promising results with a trend in NYHA class amelioration as well as right ventricular function and size improvement but need prospective validation.…”

Cardiac Resynchronization Therapy for Various Systemic Ventricular Morphologies in Patients With Congenital Heart Disease

“…Results of studies on the effects of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers and β-blockers have been mixed; some have demonstrated a significant improvement and others have not. [19][20][21][22][23][24][25][26][27] Our data on the poor response to CRT pacing for sRV patients are analogous to the effect of medical treatments for congestive heart failure in sRV patients. We do not yet know the pacing sites that are optimal for a systemic RV.…”

Chronic Heart Failure in Congenital Heart Disease

“…156,167,168 Small series in adults with TGA and a systemic RV have shown improvement in ventricular function and HF symptoms after short-term administration of β-blockers, 168 but the effects on hospital admission, sudden death, and HF-related death have not been studied. In a small, multicenter series of atrial switch patients with ICDs, treatment with β-blockers appeared protective against arrhythmic events.…”