Histopathological Changes in Aorta and Pulmonary Artery in Patients with Dextro- Transposition of Great Arteries undergoing Arterial Switch Operation: A Prospective Study

Abstract

Background: Following the arterial switch operation (ASO), there is a risk of neoaortic root enlargement, and aortic regurgitation in follow-up. This study is intended to study whether abnormalities in the histopathological findings of the neo-aorta at the time of the arterial switch operation could lead to these complications.

Mechano-biological adaptation of the pulmonary artery exposed to systemic conditions

“…Children born with hypoplastic left heart syndrome undergo the Norwood procedure in order to create a neoartic root from the pulmonary artery 4 . As a final example, the pulmonary artery and aorta are surgically switched in patients with transposition of the great arteries, placing the pulmonary root in the systemic circulation [5][6][7] . Often, failure of these procedures is related to inability of the pulmonary artery to adapt to the systemic conditions 4,8 .…”

“…Despite their similar embryological origin 9 , the aorta and the pulmonary artery show critical differences. There are three key hemodynamic differences between the aorta and the pulmonary artery: blood pressure (120/80 mmHg vs. 8-20 mmHg), peak blood flow velocity (92 ± 11 cm/sec vs. 63 ± 9 cm/sec) and blood flow acceleration rate (940 ± 161 cm/sec 2 vs. 396 ± 70 cm/sec 2 ) 7 .…”