Long-term follow-up of right ventricular function after mustard operation for transposition of the great arteries

Buch, J; Wennevold, A; Jacobsen, Jens Christian Brings; Hvid-Jacobsen, K; Lauridsen, P

doi:10.3109/14017438809106062

Cited by 21 publications

(12 citation statements)

References 34 publications

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“…Over the long-term many of these patients develop RV failure and the incidence is higher in patients who underwent an atrial switch operation. (14) The pathogenesis of systemic RV failure in the atrial switch cohort is unclear. A failing pressure overloaded systemic RV, if uncorrected, can secondarily cause diastolic LV dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Right Ventricular Myocardial Mechanics Using Velocity Vector Imaging of Cardiac MRI Cine Images in Transposition of the Great Arteries Following Atrial and Arterial Switch Operations

et al. 2015

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Objective The aim of the study was to determine right and left ventricle deformation parameters in patients with transposition of the great arteries who had undergone atrial or arterial switch procedures. Setting Patients with transposition are born with a systemic right ventricle. Historically, the atrial switch operation, in which the right ventricle remains the systemic ventricle, was performed. These patients have increased rates of morbidity and mortality. We used cardiac MRI with Velocity Vector Imaging analysis to characterize and compare ventricular myocardial deformation in patients who had an atrial switch or arterial switch operation. Design Patients with a history of these procedures, who had a clinically ordered cardiac MRI were included in the study. Consecutive 20 patients (75% males, 28.7±1.8 years) who underwent atrial switch operation and 20 patients (60% males, 17.7±1.9 years) who underwent arterial switch operation were included in the study. Four chamber and short-axis cine images were used to determine longitudinal and circumferential strain and strain rate using Vector Velocity Imaging software. Results Compared to the arterial switch group, the atrial switch group had decreased right ventricular ejection fraction and increased end-diastolic and end-systolic volumes; and no difference in left ventricular ejection fraction and volumes. The atrial switch group had decreased longitudinal and circumferential strain and strain rate. When compared to normal controls multiple strain parameters in the atrial switch group were reduced. Conclusions Myocardial deformation analysis of transposition patients reveals a reduction of right ventricular function and decreased longitudinal and circumferential strain parameters in patients with an atrial switch operation compared to those with arterial switch operation. A better understanding of the mechanisms of RV failure in TGA may lead to improved therapies and adaptation.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Right Ventricular Myocardial Mechanics Using Velocity Vector Imaging of Cardiac MRI Cine Images in Transposition of the Great Arteries Following Atrial and Arterial Switch Operations

et al. 2015

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“…When these procedures are compared in long-term follow up, there was no difference in mortality, but Senning patients had better functional status [8,9]. Late sequelae of the Senning and Mustard operations include arrhythmias [10][11][12][13], systemic ventricular dysfunction, tricuspid regurgitation [13,14], and atrial baffle obstruction and leaks [15].…”

Section: Introductionmentioning

confidence: 97%

Pulmonary arterial hypertension in patients with prior atrial switch procedure for d-transposition of great arteries (dTGA)

Yehya

Lyle

Pernetz

et al. 2010

International Journal of Cardiology

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“…10,17 Tricuspid regurgitation often coexists, and both lesions increase the propensity for atrial arrhythmias. Mild to moderate tricuspid regurgitation is very common in adult survivors and tends to progressively worsen.…”

Section: Systemic Ventricular Dysfunction and Tricuspid Regurgitationmentioning

confidence: 99%

Transposition of the Great Arteries

2006

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Abstract-Many patients with ventriculoarterial discordance have survived to adulthood. Those with complete transposition of the great arteries have often had an atrial switch procedure (Mustard or Senning operation) performed, which leaves the morphological right ventricle (RV) supporting the systemic circulation. RV failure and tricuspid regurgitation are common. Some patients may ultimately require cardiac transplantation. Sinus node dysfunction is increasingly common with longer follow-up, and some patients need pacemaker implantation. Atrial arrhythmias are frequent, and atrial flutter may be a marker for sudden death. Patients with an arterial switch procedure are also surviving to adulthood. Long-term problems include coronary stenoses, distortion of the pulmonary arteries, dilatation of the neoaortic root, and aortic regurgitation. Patients with congenitally corrected transposition have both atrioventricular and ventriculoarterial discordance and therefore also have a morphological RV and delicate tricuspid valve in the systemic circulation. Associated defects, such as abnormalities of the tricuspid valve, ventricular septal defect, and pulmonary stenosis, occur in the majority of patients. Heart block occurs with increasing age. Atrial arrhythmias occur frequently, and their occurrence should prompt a search for a hemodynamic problem. Progressive tricuspid regurgitation occurs with age and is associated with deterioration of RV function. Surgical treatment should be considered at the earliest sign of RV dilatation or dysfunction. All patients should be seen periodically in a center where expertise in the clinical evaluation, imaging, and hemodynamic assessment of adult congenital heart disease is available.

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Long-term follow-up of right ventricular function after mustard operation for transposition of the great arteries

Cited by 21 publications

References 34 publications

Evaluation of Right Ventricular Myocardial Mechanics Using Velocity Vector Imaging of Cardiac MRI Cine Images in Transposition of the Great Arteries Following Atrial and Arterial Switch Operations

Evaluation of Right Ventricular Myocardial Mechanics Using Velocity Vector Imaging of Cardiac MRI Cine Images in Transposition of the Great Arteries Following Atrial and Arterial Switch Operations

Pulmonary arterial hypertension in patients with prior atrial switch procedure for d-transposition of great arteries (dTGA)

Transposition of the Great Arteries

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