Reoperations and catheter interventions in patients with transposition of the great arteries after the arterial switch operation

Michalak, Krzysztof W.; Moll, Jadwiga; Sobczak-Budlewska, Katarzyna; Moll, Maciej; Dryżek, Paweł; Moszura, Tomasz; Szymczyk, Konrad; Moll, J

doi:10.1093/ejcts/ezw290

Cited by 33 publications

(41 citation statements)

References 17 publications

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“…3 Previous single center studies have reported incidences of pulmonary artery stenosis requiring intervention ranging from 3.8% to 28%. [4][5][6] Pulmonary artery angioplasty and/or stenting have been the most common procedures performed in these patients. [4][5][6][7][8][9] We encountered aorto-pulmonary (AP) fistulae and coronary artery compression during pulmonary artery stent procedures in this population.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary artery interventions after the arterial switch operation: Unique and significant risks

Lee

Shahbah

El‐Said

et al. 2019

Congenital Heart Disease

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Background:In the modern era, results of the arterial switch operation (ASO) for transposition of the great arteries are excellent. However, because of the LeCompte maneuver, there may be a propensity for development of pulmonary artery stenosis.We encountered atypical complications of pulmonary artery stenting in patients after the ASO, including aorto-pulmonary fistula and coronary compression. Methods:We performed a 10-year retrospective review of catheterizations performed in patients after ASO in our institution with a focus on adverse events.Results: Diagnostic and interventional catheterizations were performed in 47 patients. In 29 patients, 37 interventional procedures performed, which included pulmonary artery angioplasty and/or stenting. In this group, there were five major adverse events (14%), including three aorto-pulmonary fistulae and one coronary artery compression among patients having stent implantation or stent redilation. In addition, there were 6/37 (16%) intended stent procedures, which were aborted because there appeared to be high-risk of significant adverse events.Conclusions: This review suggests that percutaneous intervention on pulmonary artery stenosis after ASO has high-risk and should be undertaken advisedly. Prior thorough evaluation of coronary arteries is mandatory as coronary reimplantation sites may be adjacent to sites of pulmonary artery stenosis. Furthermore, if pulmonary artery stent implantation or stent redilation is contemplated, the risk of stent fracture and possible AP fistula should be recognized. Primary use of reinforced covered stents should be considered. K E Y W O R D Saorto-pulmonary fistula, arterial switch operation, pulmonary artery, stents, transposition of great vessels

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Section: Introductionmentioning

confidence: 99%

Pulmonary artery interventions after the arterial switch operation: Unique and significant risks

Lee

Shahbah

El‐Said

et al. 2019

Congenital Heart Disease

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“…In this report, 309 patients were included with all echocardiographic measurements that were performed in standardized fashion (n=1844). The rate of reintervention was 5%, which is at the lowest part of the published ranges 5,[8][9][10][11] . There was no difference in the pressure gradient in the presence or absence of an associated ventricular septal defect.…”

Section: Regarding Limited Buttons Resection Technique a Data Of 120mentioning

confidence: 86%

“…The reported incidence of reoperation related to pulmonary stenosis after the arterial switch operation ranges from 5-30% 5,[8][9][10] . Because the pulmonary artery pressure gradient can vary with the somatic growth, we sought to examine the behavior of the pulmonary artery pressure gradient over time and to determine the contributing factors and its relationship with the need for reintervention.…”

Section: Introductionmentioning

confidence: 99%

The behavior of residual pulmonary artery gradient after arterial switch operation: A longitudinal data analysis

Alkattan

Diraneyya

Elmontaser

et al. 2020

Preprint

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Objective: The arterial switch operation is the standard treatment for the transposition of the great arteries. The timely variation in the residual pressure gradient across the pulmonary arteries is ill-defined. This work is aimed to study the progressive changes in the pressure gradient across the pulmonary valve and pulmonary arteries after arterial switch operation (ASO). Methods: All eligible patients for this study who underwent arterial switch operation between 2000 and 2019 were reviewed. Transthoracic echocardiography (TTE), was used to estimate the peak pressure gradient across the pulmonary artery and its branches. The primary outcome was the total peak pressure gradient (TPG) which is the sum of peak pressure gradients across the main pulmonary artery and pulmonary artery branches. Furthermore, a longitudinal data analyses with mixed effect modeling were used to determine the independent predictors for the changes in pressure gradient. Results: 309 patients were included in the study. Over 17-year follow up, the freedom from pulmonary stenosis reintervention was 95% (16 out of the 309 patients underwent reintervention = 5%). the Longitudinal data analyses of serial 1844 echocardiographic studies for the included patients revealed that the TPG recorded in the first postoperative echocardiogram across pulmonary valve, right and left pulmonary artery branches was the most significant predictor for reintervention. Conclusion: The total peak gradient measured in the first postoperative echocardiogram is the most important predictor for reintervention. We propose that a total peak gradient in the first postoperative echocardiography of 55 mmHg or more is a predictor for reintervention The behavior of residual pulmonary artery gradient after arterial switch operation: A longitudinal data analysis ABSTRACT Objective: The arterial switch operation is the standard treatment for the transposition of the great arteries. The timely variation in the residual pressure gradient across the pulmonary arteries is ill-defined. This work is aimed to study the progressive changes in the pressure gradient across the pulmonary valve and pulmonary arteries after arterial switch operation (ASO). Methods: All eligible patients for this study who underwent arterial switch operation between 2000 and 2019 were reviewed. Transthoracic echocardiography (TTE), was used to estimate the peak pressure gradient across the pulmonary artery and its branches. The primary outcome was the total peak pressure gradient (TPG) which is the sum of peak pressure gradients across the main pulmonary artery and pulmonary artery branches. Furthermore, a longitudinal data analyses with mixed effect modeling were used to determine the independent predictors for the changes in pressure gradient. Results: 309 patients were included in the study. Over 17-year follow up, the freedom from pulmonary stenosis reintervention was 95% (16 out of the 309 patients underwent reintervention = 5%). the Longitudinal

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“…Most reoperations after the ASO occur after the first postoperative year. Freedom from reoperation has been reported in a range of 79% to 97% at 10 years [12,[14][15][16][17][18], 76% to 87% at 15 years [14,15,18,19], and 86% at 25 years (Table 1) [12].…”

Section: Current Outcomes Of the Asomentioning

confidence: 99%

Arterial Switch Operation: Operative Approach and Outcomes

Fricke

Konstantinov

2019

The Annals of Thoracic Surgery

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Reoperations and catheter interventions in patients with transposition of the great arteries after the arterial switch operation

Cited by 33 publications

References 17 publications

Pulmonary artery interventions after the arterial switch operation: Unique and significant risks

Pulmonary artery interventions after the arterial switch operation: Unique and significant risks

The behavior of residual pulmonary artery gradient after arterial switch operation: A longitudinal data analysis

Arterial Switch Operation: Operative Approach and Outcomes

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