Exercise Performance and Activity Level in Children With Transposition of the Great Arteries Treated by the Arterial Switch Operation

Beek, Elsje van; Binkhorst, Mathijs; Hoog, Marieke de; Groot, Patricia M. de; Dijk, Arie P.J. van; Schokking, Michiel; Hopman, Maria T. E.

doi:10.1016/j.amjcard.2009.09.048

Cited by 22 publications

(20 citation statements)

References 17 publications

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“…Studies report peak volume of oxygen consumption (VO 2 ) measurements of ABP patients of around 70% to 75% predicted [14,15]. During childhood, exercise performance after ASO seems better, with peak VO 2 levels averaging 80% to 85% predicted [14,17,18]. However, in our experience, adult ASO patients exhibit peak VO 2 levels similar to those seen after ABPs [19••].…”

Section: Exercise Capacitysupporting

confidence: 47%

“…However, in our experience, adult ASO patients exhibit peak VO 2 levels similar to those seen after ABPs [19••]. These modest reductions go largely unnoticed by patients themselves [15,17], a common discrepancy in congenital heart disease [20]. Although the precise mechanisms vary, decreased exercise performance after TGA repair is, at least in part, a consequence of physiological restrictions [17,21].…”

Section: Exercise Capacitymentioning

confidence: 88%

“…Studies suggest that this mechanism contributes more to exercise intolerance after an ABP than either impaired RV contractility or chronotropic incompetence, both of which affect this group [21-23]. Although peak exercise heart rates are reduced after ASO [17], the reduction is sufficient to be classed as abnormal in only 5% of cases and is unrelated to peak exercise capacity [18]. It seems that issues related to pulmonary blood flow may be more important in this group of patients [18,24].…”

Section: Exercise Capacitymentioning

confidence: 96%

“…These modest reductions go largely unnoticed by patients themselves [15,17], a common discrepancy in congenital heart disease [20]. Although the precise mechanisms vary, decreased exercise performance after TGA repair is, at least in part, a consequence of physiological restrictions [17,21]. There is evidence to suggest that the stiff, noncompliant baffles of an ABP impair ventricular filling and limit ability to augment stroke volume during exercise [21,22].…”

Section: Exercise Capacitymentioning

confidence: 99%

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Monitoring the Patient with Transposition of the Great Arteries: Arterial Switch Versus Atrial Switch

2011

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Sufficient time has passed that adult congenital heart disease (ACHD) specialists now frequently encounter survivors born with complete transposition of the great arteries and palliated with an atrial or arterial switch procedure. To ensure the ongoing health of these patients, it is of paramount importance that their surgeries are understood and that physicians are aware of and remain vigilant for potential late complications. Adult survivors should be assessed annually in a regional ACHD center. Clinical assessment, electrocardiogram, and multimodality imaging are the mainstay of routine monitoring. Doppler echocardiography is the first-line imaging modality; other diagnostic tests are tailored to seek specific long-term complications. Clinicians, specialists in cardiovascular imaging, nurses and others involved in the delivery of care need special training and expertise. Care for these complex patients is best provided by multidisciplinary teams located in regional ACHD centers with access to adequate human and structural resources.

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Section: Exercise Capacitysupporting

confidence: 47%

Section: Exercise Capacitymentioning

confidence: 88%

Section: Exercise Capacitymentioning

confidence: 96%

Section: Exercise Capacitymentioning

confidence: 99%

See 2 more Smart Citations

Monitoring the Patient with Transposition of the Great Arteries: Arterial Switch Versus Atrial Switch

2011

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“…To obtain information on self-perceived fitness and health, physical activity in daily life, including sports, participation at school, and leisure, a questionnaire [4, 11] from the Department of Integrative Physiology, St. Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands, was used. The results were compared with those from healthy control subjects [11].…”

Section: Methodsmentioning

confidence: 99%

Exercise Capacity in Children With Isolated Congenital Complete Atrioventricular Block: Does Pacing Make a Difference?

et al. 2012

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The management of patients with isolated congenital complete atrioventricular block (CCAVB) has changed during the last decades. The current policy is to pace the majority of patients based on a variety of criteria, among which is limited exercise capacity. Data regarding exercise capacity in this population stems from previous publications reporting small case series of unpaced patients. Therefore, we have investigated the exercise capacity of a group of contemporary children with CCAVB. Sixteen children (mean age 11.5 ± 4; seven boys, nine girls) with CCAVB were tested. In 13 patients, a median number of three pacemakers were implanted, whereas in three patients no pacemaker was given. All patients had an echocardiogram and completed a cardiopulmonary cycle exercise test. Exercise parameters were determined and compared with reference values obtained from healthy Dutch peers. The peak oxygen uptake/body mass was reduced to 34.4 ± 9.5 ml kg−1 min−1 (79 ± 24% of predicted) and the ventilatory threshold was reduced to 52 ± 17% of peak oxygen uptake (78 ± 21% of predicted), whereas the peak work load/body mass was 2.8 ± 0.6 W/kg (91 ± 24% of predicted), which was similar to controls. Importantly, 25% of the paced patients showed upper rate restriction by the pacemaker. In conclusion, children with CCAVB show a reduced peak oxygen uptake and ventilatory threshold, whereas they show normal peak work rates. This indicates that they generate more energy during exercise from anaerobic energy sources. Paced children with CCAVB do not perform better than unpaced children.

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9 Kinderfysiotherapie bij pulmonale en cardiale aandoeningen

Giessen¹,

Riet²

2016

Kinderfysiotherapie

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Exercise Performance and Activity Level in Children With Transposition of the Great Arteries Treated by the Arterial Switch Operation

Cited by 22 publications

References 17 publications

Monitoring the Patient with Transposition of the Great Arteries: Arterial Switch Versus Atrial Switch

Monitoring the Patient with Transposition of the Great Arteries: Arterial Switch Versus Atrial Switch

Exercise Capacity in Children With Isolated Congenital Complete Atrioventricular Block: Does Pacing Make a Difference?

9 Kinderfysiotherapie bij pulmonale en cardiale aandoeningen

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