Aortic Valve Regurgitation After Arterial Switch Operation for Transposition of the Great Arteries

Losay, J; Touchot, Anita; Capderou, André; Piot, J. D.; Belli, Emrè; Planché, C; Sérraf, Alain

doi:10.1016/j.jacc.2005.12.061

Cited by 152 publications

(121 citation statements)

References 29 publications

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“…3,21,22 In a subanalysis of adult patients with simple TGA after 1-stage versus 2-stage ASO, we found significantly increased cross-sectional areas of the aortic root and the ascending aorta in the latter group, whereas the severity of AR was not different. Although we observed an overall relationship between the proximal aortic cross-sectional area and AR, the absence of significant differences of AR between 1-and Figure 6.…”

Section: Aortic Dimensions and Aortic Insufficiencymentioning

confidence: 68%

“…The fate of the aorta and aortic valve has been assessed in previous studies. [3][4][5] Most of the patients show nonprogressive dilatation of the aortic root, but few cases experience aortic insufficiency. 6 In addition, reduced proximal aortic elasticity, structural abnormalities of the arterial walls, and increased carotid artery stiffness have been reported in TGA patients.…”

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confidence: 99%

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Implications of Early Aortic Stiffening in Patients With Transposition of the Great Arteries After Arterial Switch Operation

Voges

Jerosch‐Herold

Hedderich

et al. 2013

Circ: Cardiovascular Imaging

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Background-The elastic function of the aorta in patients with transposition of the great arteries after arterial switch operation (ASO) is suspected to be important for long-term prognosis. ; P<0.01). Aortic distensibility correlated negatively with the aortic areas (P<0.01). Pulse wave velocity was higher in adults after ASO (5.0±1.0 versus 3.8±1.3 m/s; P<0.01). In contrast to controls pulse wave velocity and distensibility correlated with age in patients (P=0.04 to <0.01), LV mass was higher in patients (P=0.02). LA volumes correlated negatively with aortic root and ascending aortic distensibility and positively with pulse wave velocity (P<0.05). In patients, LA passive emptying function was lower (27.3±8.9 versus 41.1±6.0; P<0.01) and correlated with aortic root distensibility (P=0.004). Methods and Results Conclusions-Reduced

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Section: Aortic Dimensions and Aortic Insufficiencymentioning

confidence: 68%

mentioning

confidence: 99%

Implications of Early Aortic Stiffening in Patients With Transposition of the Great Arteries After Arterial Switch Operation

Voges

Jerosch‐Herold

Hedderich

et al. 2013

Circ: Cardiovascular Imaging

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“…15 Patients with Taussig-Bing anomaly and other forms of double outlet right ventricle have a higher risk of developing significant AI and of requiring aortic valve replacement compared with patients with transposition of the great arteries. 16,17 Prior pulmonary artery banding (which may distort and increase flow velocity across the native pulmonary valve), older operative age, and higher operative weights have previously been associated with the development of significant AI in Taussig-Bing anomaly, 6 which further supports singlestage repair as a possible protective strategy. In this cohort, we demonstrated a low rate of significant AI after primary ASO.…”

Section: Neoaortic Insufficiencymentioning

confidence: 95%

Primary Arterial Switch Operation as a Strategy for Total Correction of Taussig–Bing Anomaly

et al. 2013

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The second most common variant of double outlet right ventricle, the anomaly was originally distinguished by a transposed aorta arising entirely from the right ventricle, a pulmonary artery overriding a ventricular septal defect (VSD), side-by-side great vessels, and bilateral subarterial conus with absence of pulmonary-mitral fibrous continuity.1,2 Most surgical series have expanded the definition to include any double outlet right ventricle (with or without pulmonary-mitral continuity) with a subpulmonary VSD, in which left ventricular output flows preferentially to the pulmonary artery. [2][3][4] Despite >30 years of experience with various management strategies, Taussig-Bing anomaly continues to present a considerable surgical challenge. This is largely related to associated anomalies, the most significant of which may be the varying degrees of right ventricular outflow tract and aortic arch obstruction caused by a malaligned ventricular septum. 5 Today, primary arterial switch operation (ASO) with VSD closure is the gold standard for Taussig-Bing anomaly.2,6,7 Significant rates of reintervention, mortality, and neoaortic complications have been demonstrated in studies of this lesion, particularly in patients who had undergone palliative procedures such as pulmonary artery banding before definitive repair. 6,7 Since 1990, single-stage correction with primary ASO has been our institution's practice for all children with Taussig-Bing anomaly. We aimed to describe the long-term outcomes and functional status of patients managed with this surgical approach and to identify factors that predict mortality, reintervention, neoaortic insufficiency (AI), and neoaortic root dilation. Methods Patient SelectionAfter obtaining approval from the Institutional Review Board of Columbia University with a waiver of consent, we retrospectively reviewed our hospital and surgical databases for all admissions diagnosed with transposition of the great arteries or double outlet right ventricle. Patients with Taussig-Bing anomaly were identified as those with a transposed aorta and a pulmonary artery arising in Background-Studies of the arterial switch operation for Taussig-Bing anomaly demonstrate significant rates of reintervention and mortality, particularly after initial palliation to delay complete repair. We aimed to describe the longterm outcomes of our 21-year practice of single-stage arterial switch operation for all patients with Taussig-Bing anomaly. Methods and Results-A retrospective study was performed, and 43 patients with Taussig-Bing anomaly were identified between 1990 and 2011. Median age at arterial switch operation was 7 (range, 2-192) days, and median operative weight was 3.2 (1.4-6.2) kg. Aortic arch obstruction was present in 30 patients (70%). Hospital mortality was 7% (n=3). Follow-up was available for 37 hospital survivors at a mean of 8.1 (±6.3) years. Late mortality was 2% (n=1). At follow-up, all patients were in New York Heart Association functional class I. Freedom from transcatheter or surgical reinte...

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“…Clinical findings of AR or PS may be present. Echocardiography is the key diagnostic technique, providing information on LV function (global and regional), stenosis at the arterial anastomotic sites, most commonly PS, neoaortic valve regurgitation, dimension of the ascending aorta, 118 and the acute angulation of the aortic arch. 112 The pulmonary trunk, the bifurcation, and both branches should be evaluated for the presence, localization, and severity of stenoses.…”

Section: Arterial Switch Operation Diagnostic Work-upmentioning

confidence: 99%

ESC Guidelines for the management of grown-up congenital heart disease (new version 2010)

Baumgartner¹,

Bonhoeffer²,

Groo³

et al. 2012

Revista Portuguesa de Cardiologia (English Edition)

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Aortic Valve Regurgitation After Arterial Switch Operation for Transposition of the Great Arteries

Abstract: After ASO, AR was observed and was related to VSD with attending high pressure and flow and AR at discharge. Progression of AR was slow, but incidence increased with follow-up. Reoperation for AR was rare. Late aortic valve function warrants long-term monitoring.

Cited by 152 publications

References 29 publications

Implications of Early Aortic Stiffening in Patients With Transposition of the Great Arteries After Arterial Switch Operation

Implications of Early Aortic Stiffening in Patients With Transposition of the Great Arteries After Arterial Switch Operation

Primary Arterial Switch Operation as a Strategy for Total Correction of Taussig–Bing Anomaly

ESC Guidelines for the management of grown-up congenital heart disease (new version 2010)

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