Long-term Management of the Arterial Switch Patient

Overview

Journal Curr Cardiol Rep

Publisher Current Science

Specialty Cardiology & Vascular Diseases

Date 2018 Jun 28

PMID 29946937

Citations 10

Authors

Jared Kirzner

Altaf Pirmohamed

Jonathan Ginns

Harsimran S Singh

Affiliations

Soon will be listed here.

Abstract

Purpose Of Review: This review paper describes the management of patients with dextro-transposition of the great arteries (D-TGA) with a focus on the complications seen and the appropriate care required to identify and prevent adverse events.

Recent Findings: D-TGA is a form of cyanotic congenital heart disease (CHD) representing ~ 3% of all CHD and almost 20% of all cyanotic CHD. Since the late 1980s, standard of care is to repair these patients with an arterial switch operation (ASO) as opposed to a Mustard/Senning operation. The long-term survival and complication rates are superior in the ASO. Long-term follow-up is recommended for all D-TGA patients and includes management with adult congenital heart disease specialists and the use of echocardiography and advanced imaging with CT or MRI. The most common complications seen are pulmonary stenosis, coronary artery stenosis, and neo-aortic regurgitation. Careful evaluation of new symptoms or declining function is essential in preventing and treating these long-term sequelae.

Citing Articles

Fifth decennium after the arterial switch operation for transposition of the great arteries.

Wijk S, Wulfse M, Driessen M, Slieker M, Doevendans P, Schoof P Int J Cardiol Congenit Heart Dis. 2024; 12:100451.

PMID: 39711819 PMC: 11657936. DOI: 10.1016/j.ijcchd.2023.100451.

Hemodynamic evaluation of the pulmonary arteries and aorta using 4D flow cardiac MRI in children and young adults with dextro-transposition of the great arteries after the arterial switch operation.

Calderon K, Sodhi A, Johnson E, Markl M, Robinson J, Rigsby C Pediatr Radiol. 2024; 55(2):280-296.

PMID: 39704828 DOI: 10.1007/s00247-024-06110-4.

Brazilian Guideline for Exercise Testing in Children and Adolescents - 2024.

Carvalho T, Freitas O, Chalela W, Hossri C, Milani M, Buglia S Arq Bras Cardiol. 2024; 121(8):e20240525.

PMID: 39292116 PMC: 11495813. DOI: 10.36660/abc.20240525.

Prenatal transposition of great arteries diagnosis and management: a Chinese single-center study.

Guo J, Ling W, Dang T, Guo S, Ma H, Huang Q Front Cardiovasc Med. 2024; 11:1341005.

PMID: 38510199 PMC: 10951393. DOI: 10.3389/fcvm.2024.1341005.

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

Walter C, Escobar-Diaz M, Cesar S, Garrido B, Sanchez-de-Toledo J Ann Pediatr Cardiol. 2023; 15(5-6):447-452.

PMID: 37152511 PMC: 10158475. DOI: 10.4103/apc.apc_46_22.

References

Ravi P, Mills L, Fruitman D, Savard W, Colen T, Khoo N . Population trends in prenatal detection of transposition of great arteries: impact of obstetric screening ultrasound guidelines. Ultrasound Obstet Gynecol. 2017; 51(5):659-664. DOI: 10.1002/uog.17496. View

RASHKIND W, Miller W . Creation of an atrial septal defect without thoracotomy. A palliative approach to complete transposition of the great arteries. JAMA. 1966; 196(11):991-2. View

Lui G, Fernandes S, McElhinney D . Management of cardiovascular risk factors in adults with congenital heart disease. J Am Heart Assoc. 2014; 3(6):e001076. PMC: 4338694. DOI: 10.1161/JAHA.114.001076. View

Lim H, Kim W, Lee J, Kim Y . Long-term results of the arterial switch operation for ventriculo-arterial discordance. Eur J Cardiothorac Surg. 2012; 43(2):325-34. DOI: 10.1093/ejcts/ezs264. View

Qamar Z, Goldberg C, Devaney E, Bove E, Ohye R . Current risk factors and outcomes for the arterial switch operation. Ann Thorac Surg. 2007; 84(3):871-8. DOI: 10.1016/j.athoracsur.2007.04.102. View

Hu S, Liu Z, Li S, Shen X, Wang X, Liu J . Strategy for biventricular outflow tract reconstruction: Rastelli, REV, or Nikaidoh procedure?. J Thorac Cardiovasc Surg. 2008; 135(2):331-8. DOI: 10.1016/j.jtcvs.2007.09.060. View

Gerelli S, Pontailler M, Rochas B, Angeli E, van Steenberghe M, Bonnet D . Single coronary artery and neonatal arterial switch operation: early and long-term outcomes. Eur J Cardiothorac Surg. 2017; 52(1):90-95. DOI: 10.1093/ejcts/ezx046. View

Pretre R, Tamisier D, Bonhoeffer P, Mauriat P, Pouard P, Sidi D . Results of the arterial switch operation in neonates with transposed great arteries. Lancet. 2001; 357(9271):1826-30. DOI: 10.1016/S0140-6736(00)04957-6. View

Reybrouck T, Eyskens B, Mertens L, Defoor J, Daenen W, Gewillig M . Cardiorespiratory exercise function after the arterial switch operation for transposition of the great arteries. Eur Heart J. 2001; 22(12):1052-9. DOI: 10.1053/euhj.2000.2425. View

10.

Lange R, Cleuziou J, Horer J, Holper K, Vogt M, Tassani-Prell P . Risk factors for aortic insufficiency and aortic valve replacement after the arterial switch operation. Eur J Cardiothorac Surg. 2008; 34(4):711-7. DOI: 10.1016/j.ejcts.2008.06.019. View

11.

Hutter P, Kreb D, Mantel S, Hitchcock J, Meijboom E, Bennink G . Twenty-five years' experience with the arterial switch operation. J Thorac Cardiovasc Surg. 2002; 124(4):790-7. DOI: 10.1067/mtc.2002.120714. View

12.

Sterrett L, Schamberger M, Ebenroth E, Siddiqui A, Hurwitz R . Myocardial perfusion and exercise capacity 12 years after arterial switch surgery for D-transposition of the great arteries. Pediatr Cardiol. 2011; 32(6):785-91. DOI: 10.1007/s00246-011-9975-y. View

13.

Horer J, Schreiber C, Cleuziou J, Vogt M, Prodan Z, Busch R . Improvement in long-term survival after hospital discharge but not in freedom from reoperation after the change from atrial to arterial switch for transposition of the great arteries. J Thorac Cardiovasc Surg. 2009; 137(2):347-54. DOI: 10.1016/j.jtcvs.2008.09.015. View

14.

Co-Vu J, Ginde S, Bartz P, Frommelt P, Tweddell J, Earing M . Long-term outcomes of the neoaorta after arterial switch operation for transposition of the great arteries. Ann Thorac Surg. 2012; 95(5):1654-9. DOI: 10.1016/j.athoracsur.2012.10.081. View

15.

Daebritz S, Nollert G, Sachweh J, Engelhardt W, von Bernuth G, Messmer B . Anatomical risk factors for mortality and cardiac morbidity after arterial switch operation. Ann Thorac Surg. 2000; 69(6):1880-6. DOI: 10.1016/s0003-4975(00)01241-8. View

16.

Moene R . Congenital mitral valve anomalies in transposition of the great arteries. Am J Cardiol. 1982; 49(8):1972-8. DOI: 10.1016/0002-9149(82)90217-x. View

17.

Wernovsky G, Mayer Jr J, Jonas R, Hanley F, Blackstone E, KIRKLIN J . Factors influencing early and late outcome of the arterial switch operation for transposition of the great arteries. J Thorac Cardiovasc Surg. 1995; 109(2):289-301; discussion 301-2. DOI: 10.1016/S0022-5223(95)70391-8. View

18.

Deal B, Chin A, Sanders S, Norwood W, Castaneda A . Subxiphoid two-dimensional echocardiographic identification of tricuspid valve abnormalities in transposition of the great arteries with ventricular septal defect. Am J Cardiol. 1985; 55(9):1146-51. DOI: 10.1016/0002-9149(85)90652-6. View

19.

Konstantinov I, Alexi-Meskishvili V, Williams W, Freedom R, Van Praagh R . Atrial switch operation: past, present, and future. Ann Thorac Surg. 2004; 77(6):2250-8. DOI: 10.1016/j.athoracsur.2003.10.018. View

20.

Reller M, Strickland M, Riehle-Colarusso T, Mahle W, Correa A . Prevalence of congenital heart defects in metropolitan Atlanta, 1998-2005. J Pediatr. 2008; 153(6):807-13. PMC: 2613036. DOI: 10.1016/j.jpeds.2008.05.059. View