The world upside down - after 20 years of follow-up of dextro-transposition of the great arteries

• Type: Article in International Scientific Journal
• Date: 2024

Authors

Pinto, RA (Author) Other; Marques, CA (Author) FMUP; Proença, T (Author) Other; Carvalho, MM (Author) Other; Cruz, C (Author) Other; Macedo, F (Author) Other

Journal

The Journal is awaiting validation by the Administrative Services.

Title: Monaldi Archives for Chest Disease

Vol. 94

ISSN: 1122-0643

Indexing

ISI Web of Knowledge - 0 Citations

Other information

Authenticus ID: P-00Y-VYW

DOI: 10.4081/monaldi.2023.2551

Abstract (EN): Dextro-transposition of the great arteries (D-TGA) is a congenital heart disease (CHD) classically palliated with atrial switch (ATR-S) and nowadays corrected with arterial switch (ART -S). Our aim was to observe a group of D-TGA patients followed in an adult CHD outpatient clinic. We analyzed a group of D-TGA patients born between 1974 and 2001. Adverse events were defined as a composite of death, stroke, myocardial infarction or coronary revascularization, arrhythmia, and ventricular, baffle, or significative valvular dysfunction. A total of 79 patients were enrolled, 46% of whom were female, with a mean follow-up of 27 +/- 6 years after surgery. ATR-S was performed in 54% and ART -S in 46%; the median age at procedure was 13 months and 10 days, respectively. During follow-up, almost all ART -S remained in sinus rhythm versus 64% of ATR-S (p=0.002). The latter group had a higher incidence of arrhythmias (41% versus 3%, p<0.001), mostly atrial flutter or fibrillation; the median time to first arrhythmia was 23 years. Systemic ventricle systolic dysfunction (SVSD) was more frequent in ATR-S (41% versus 0%, p<0.001); the mean time to SVSD was 25 years. In ART -S, the most frequent complication was significant valvular regurgitation (14%). Regarding time -to -event analysis, 80% and 40% of ATR-S maintained adverse events -free after 20 and 30 years, respectively; the time -to -first adverse event was 23 years, and there was no difference compared to ART -S (Log-rank=0.596). ART -S tended to maintain more preserved biventricular function than ATR-S (Log-rank=0.055). After a long term free of adverse events, ATR-S patients experienced more arrhythmias and SVSD. ART -S complications were predominantly anastomosis-related; SVSD or arrhythmias were rare.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 5