Evaluation of Left Ventricular Function Long Term After Arterial Switch Operation for Transposition of the Great Arteries

Wijk, Sebastiaan Wh van; Driessen, Mieke M. P.; Meijboom, Folkert J.; Takken, Tim; Doevendans, Pieter A.; Breur, Johannes M.P.J.

doi:10.1007/s00246-018-1977-6

Cited by 14 publications

(8 citation statements)

References 27 publications

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“…These results are in keeping with a previous study from van Wijk et al who analysed LVEF and LV global longitudinal strain with echocardiography and did not find any differences between complex and simple TGA. 23 It also supports a report from Tobler et al who used CMR to study the coronary anatomy and myocardial viability and did not find any abnormality in patients with an unusual coronary pattern. 29 In keeping with Brown et al, the present data support the notion that the coronary artery anatomy is not a risk factor for longer term outcome of TGA after ASO.…”

Section: Comparison Of Tga Subgroupssupporting

confidence: 86%

Ventricular and atrial function and deformation is largely preserved after arterial switch operation

Schuwerk

Freitag‐Wolf

Krupičková

et al. 2021

Heart

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ObjectiveTo test the hypothesis that ventricular and atrial function are different between patients with transposition of the great arteries (TGA) after arterial switch operation (ASO) and healthy controls.Methods103 consecutive patients with TGA (median age: 16.7 years, 4.3–39.6 years, 71.8% male) were compared with 77 controls (median age: 15.4 years, 6.3–43.2 years, 66.2% male). Biventricular and biatrial function were assessed using standard cardiovascular magnetic resonance (CMR) techniques and feature tracking. Group comparison was performed with conventional non-parametrical statistics and machine learning methods to find the variables most discriminative between patients and controls. These variables were used to build a multivariable logistic regression model to assess the case–control status.ResultsMarkers of left and right ventricular function (LV; RV) (ejection fraction, MAPSE, TAPSE, LV long-axis strain) as well as LV global longitudinal (−20.7 (−24.1; −17.9) vs −23.7 (−26.1; −21.6), p<0.001), circumferential (−29.4 (−32.2; −26.5) vs −30.5 (−33.6; 29), p=0.001) and atrial longitudinal strain (left atrium (LA): 23.3 (18.6; 28.8) vs 36.7 (30.7; 44), p<0001; right atrium: 21.7 (18.2; 27.8) vs 34.9 (26.9; 40.3), p<0.001) were reduced in patients compared with controls using non-parametrical testing. The logistic regression model including the most discriminative variables from univariate and machine learning analysis demonstrated significant differences between patients and controls only for TAPSE and LA global longitudinal strain.ConclusionsBiventricular and biatrial function are largely preserved after ASO for TGA. Using a comprehensive CMR protocol along with statistical machine learning methods and a regression approach, only RV longitudinal function and LA function are significantly impaired.

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Section: Comparison Of Tga Subgroupssupporting

confidence: 86%

Ventricular and atrial function and deformation is largely preserved after arterial switch operation

Schuwerk

Freitag‐Wolf

Krupičková

et al. 2021

Heart

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“…Our finding that one in four ASO patients suffers from a reduced exercise capacity is in line with other reports in the literature [4,[7][8][9][10]. Data on exercise capacity throughout life are highly relevant, since a decreased exercise capacity has been associated with a decreased quality of life [11] and an adverse prognosis in patients with congenital heart disease [12].…”

Section: Discussionsupporting

confidence: 91%

“…Several patients included for this study were part of a separate prospective study executed in our center. This study was approved by the local Medical Ethical Committee (study number 10-289) [7].…”

Section: Study Populationmentioning

confidence: 99%

Echocardiography and MRI parameters associated with exercise capacity in patients after the arterial switch operation

Warmerdam

Magni

Leiner

et al. 2020

Journal of Cardiology

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Background: The arterial switch operation (ASO) for transposition of the great arteries has excellent survival, but a substantial number of patients suffer from a reduced exercise capacity. The goal of this study was to identify imaging parameters associated with a reduced exercise capacity in patients after ASO. Methods: A retrospective analysis was performed of ASO patients who underwent cardiopulmonary exercise testing (CPET) between 2007 and 2017. Reduced exercise performance was defined as a reduced workload peak (W peak ) with Z-score <À2 or a peak oxygen uptake indexed for weight (VO 2peak /kg) with Z-score <À2. Data on echocardiography and cardiac magnetic resonance performed within 1 year of the CPET were collected for comparison. Results: A total of 81 ASO patients (age 17 AE 7 years) were included. Reduced exercise performance was found in 22 patients (27%) as expressed by either a reduced W peak and/or a reduced VO 2peak /kg. Main pulmonary artery gradient and tricuspid regurgitation gradient by echocardiography were found to be associated with reduced W peak (p = 0.031; p = 0.020, respectively). The main pulmonary artery gradient and tricuspid regurgitation gradient by echocardiography were found to be associated with reduced VO 2peak /kg (p = 0.009; p = 0.019, respectively). No left ventricular parameters were found to be associated with abnormal exercise performance. Conclusion: This study demonstrates that ASO patients frequently experience reduced exercise capacity. Echocardiographic evidence of main pulmonary artery stenosis and increased right ventricular pressure were associated with reduced exercise capacity, and are therefore key to monitor during serial follow-up of ASO patients.

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“…[ 10 11 12 ] On the contrary, in the current post-ASO era, there is lesser focus on the echocardiographic assessment of RV after the ASO as opposed to the atrial switch operation. [ 13 14 15 16 17 18 19 ] Detailed functional evaluation of both ventricles, especially the RV, is not routinely practiced at many centers. [ 7 20 21 22 ]…”

Section: Introductionmentioning

confidence: 99%

Functional and morphometric changes in children after neonatal arterial switch operation for transposition of the great arteries

Walter¹,

Escobar-Diaz²,

César³

et al. 2022

Annals of Pediatric Cardiology

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Background: The increase in the survival of patients with D-Transposition of the great arteries (TGA) after arterial switch operation (ASO) has now turned our focus to the evaluation of mid and long-term outcomes. Although most patients are followed by conventional echocardiography, the study of cardiac functionality and morphometric parameters in children with TGA after ASO is scarce. The present study aims to describe the functional and morphometric echocardiographic changes in children after ASO. Methods: We performed an observational study in patients aged 1–5 years with TGA who underwent neonatal ASO. Morphometric and functional echocardiographic parameters were analyzed in 21 patients and compared with 52 age-matched healthy controls. Results: We found morphological and functional changes, especially in the right ventricle, which is more globular (right ventricle [RV] basal sphericity index 1.5 vs. 1.8, P = 0.016), and with a decreased systolic function compared to healthy controls (fractional area change 51 vs. 58%, P = 0.006; tricuspid annular plane systolic excursion 13 vs. 20 mm, P = 0.001; s’ 7 vs. 12 cm/s, P = 0.001). In the speckle-tracking strain imaging, there was a decrease in the longitudinal deformation of the apical septal myocardium (−23% vs. −27%; P = 0.005). Preoperative systemic overload to the right ventricle could be an important factor in the origin of these changes. Conclusions: In patients with TGA after ASO, there are morphometric and functional echocardiographic changes, such as globular form and decreased function, especially in the RV; the effect of these changes on long-term outcomes would require prospective follow-up studies.

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Evaluation of Left Ventricular Function Long Term After Arterial Switch Operation for Transposition of the Great Arteries

Cited by 14 publications

References 27 publications

Ventricular and atrial function and deformation is largely preserved after arterial switch operation

Ventricular and atrial function and deformation is largely preserved after arterial switch operation

Echocardiography and MRI parameters associated with exercise capacity in patients after the arterial switch operation

Functional and morphometric changes in children after neonatal arterial switch operation for transposition of the great arteries

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