HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Shirin Lalezari Mark G. Hazekamp Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Vandekerckhove, K. D.H.M. Articles by Hazekamp, M. G. Search for Related Content PubMed Articles by Vandekerckhove, K. D.H.M. Articles by Hazekamp, M. G. Related Collections Congenital - cyanotic Great vessels

Long-term follow-up of arterial switch operation with an emphasis on function and dimensions of left ventricle and aorta

Department of Pediatric Cardiology and Cardiac Surgery, Leiden University Medical Centre, Leiden, The Netherlands

Received 3 September 2008; received in revised form 14 December 2008; accepted 18 December 2008.

^_* Corresponding author. Address: University Hospital Gent, De Pintelaan 185, B9000 Gent, Belgium. Tel.: +32 93325838; fax: +32 93323856. (Email: Kristof.vandekerckhove{at}ugent.be).

Objective: To analyze size and function of aortic root and left ventricle as well as quality of life in patients 20 years after arterial switch procedure. Methods: Thirty-nine patients who underwent arterial switch operation between 1977 and 1989 were examined. Perioperative and follow-up data were analyzed. Evaluation included clinical assessment, ECG, echocardiography and quality of life questionnaire. Results: Patients had simple transposition (24), transposition with ventricle septal defect (7), Taussig-Bing anomaly (4) or transposition with ventricle septal defect and aortic arch obstruction (4). Mean age at evaluation was 19.9 ± 2.6 years. Seven patients required reintervention for pulmonary stenosis (4), coarctation (2) and subaortic stenosis, followed by valve replacement 10 years later (1). Arrhythmia occurred in four patients. Patients were in New York Heart Association functional class I (38) or II (1). Quality of life scores were comparable to normal controls except for the lower score in the domains of vitality, aggressive and depressive mood. Diameters of aortic annulus, sinus of Valsalva and sinotubular junction were 26.5 ± 4.1, 36.5 ± 5.6 and 29.2 ± 6.6 mm respectively. Sixty-five percent of sinus of Valsalva and 38% of sinotubular junction indexed to body surface area fall outside the 95% confidence interval. Aortic regurgitation was absent in 72%, mild in 13% and moderate in 15%. No patient had severe regurgitation. Patients without regurgitation had smaller diameters of annulus (p = 0.005) and sinus of Valsalva (p = 0.01). Left ventricular end-diastolic and end-systolic diameters were 51 ± 7 mm and 34 ± 6 mm respectively. Fractional shortening was 34 ± 5%; no regional wall motion abnormalities were observed. Conclusions: Clinical outcome is good 20 years after arterial switch operation and aortic valve function remains preserved in most patients. However, aortic root dilatation is present in two thirds of patients emphasizing the need for careful follow-up.

Key Words: Arterial switch operation • Transposition of the great arteries • Neo-aorta • Aortic regurgitation • Aortic dilatation

This article has been cited by other articles:

				S. Lalezari, E. A.F. Mahtab, M. M. Bartelings, L. J. Wisse, M. G. Hazekamp, and A. C. Gittenberger-de Groot The outflow tract in transposition of the great arteries: an anatomic and morphologic study. Ann. Thorac. Surg., October 1, 2009; 88(4): 1300 - 1305. [Abstract] [Full Text] [PDF]