Prevalence and predictors of neoaortic regurgitation after arterial switch operation for transposition of the great arteries

Abstract

After arterial switch operation, there is an increasing frequency of neoaortic regurgitation, which may lead to significant valvular dysfunction later in life. The trap-door type of coronary reimplantation is associated with an increased risk for valvular dysfunction, possibly because of a distortion of the sinotubular junction geometry. For this reason, we recommend the punch technique for repair in all but the most complicated coronary pattern.

ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease

“…Echocardiography after ASO may demonstrate minimal findings or 1 or more of the recognized complications after ASO, which include the following: 1) stenosis at the arterial anastomotic sites, most commonly PS 567 ; 2) aortic root dilatation; and 3) neoaortic valve regurgitation (native pulmonary valve). 569 Coronary complications cannot be assessed adequately by echocardiography, but stress echocardiography may facilitate detection of ischemia. CT angiography has been used recently.…”

ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease: Executive Summary

“…164 Echocardiography after ASO may demonstrate minimal findings or 1 or more of the recognized complications after ASO, which include the following: 1) stenosis at the arterial anastomotic sites, most commonly PS 165 ; 2) aortic root dilatation; and 3) neoaortic valve regurgitation (native pulmonary valve). 166 Coronary complications cannot be assessed adequately by echocardiography, but stress echocardiography may facilitate detection of ischemia. CT angiography has been used recently.…”

Early and mid-term follow-up of patients receiving arterial switch operation: a single-center experience

“…The risk factors for neoAR development are reported to be arterial size discrepancy, previous pulmonary artery band, older age at time of ASO, presence of VSD and the trap-door type of coronary reimplantation (6,(21)(22)(23). In our study, there was a relatively high incidence of trivial or mild aortic valve regurgitation, but the rate of moderate to severe aortic valve regurgitation was low.…”

“…Coronary artery reimplantation to the neoaorta has been performed by different techniques including various shaped button techniques and the trap door technique (6). In our department of Wuhan Union Hospital, we have employed split incision for coronary reimplantation.…”