WSS and flow patterns in the ascending aorta in patients with BAVs without concomitant valve or vessel disease are significantly different compared with TAV. The significantly higher shear forces may have an impact on the development of aortic dilation in patients with BAVs.

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Consecutive outpatients who had undergone the atrial switch operation or who had ccTGA without previous heart surgery were invited to participate. Patients with a permanent pacemaker in situ were excluded. All patients received routine clinical evaluation in the outpatient clinic, including determination of the grade of tricuspid regurgitation by echocardiography. The degree of tricuspid regurgitation was qualitatively assessed by color Doppler imaging and graded as 0 (no regurgitation), I (mild regurgitation), II (moderate Circ J 2008; 72: 1130 -1135 (Received July 1, 2007 revised manuscript received February 6, 2008; accepted February 25, 2008 Background Patients after atrial switch operation for transposition of the great arteries have limited exercise performance. Rigid atrial baffles may cause a relative preload reduction. Previous studies have had suboptimal control groups, which ideally should consist of patients with congenitally corrected transposition of the great arteries (ccTGA) without previous heart surgery, having a systemic right ventricle, but lacking rigid atrial baffles. Therefore the aim of this study was to test the impact of atrial baffles by comparing 12 atrial switch patients with 11 ccTGA patients. Methods and ResultsSystemic right ventricular stroke volume (SV), heart rate, cardiac index, and other parameters were assessed during rest and dobutamine stress magnetic resonance imaging. The most important difference between the groups was that the atrial switch patients could not increase SV during stress, whereas ccTGA patients increased it significantly. There was no difference between groups in the rise of the cardiac index. Heart rate increased significantly more in atrial switch patients than in ccTGA patients. ConclusionsThe results support the hypothesis that atrial baffles restrict a rise in SV under dobutamine stress in patients after atrial switch operation for transposition of the great arteries. (Circ J 2008; 72: 1130 -1135

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