Understanding the mechanism for branch pulmonary artery stenosis after the arterial switch operation for transposition of the great arteries

Abstract

Neo-pulmonary to neo-aortic geometry as well as post-operative compression of the LPA by an enlarged aorta impact LPA size and perfusion of the left lung.

Quantification of Pulmonary Artery Configuration after the Arterial Switch Operation: A Pilot Study

“…The enlarged root creates a substrate for PA elongation or compression at the branch level. This was observed during this analysis and has been confirmed by other studies [ 10 ].…”

Quantification of Pulmonary Artery Configuration after the Arterial Switch Operation: A Pilot Study

“…The enlarged root creates a substrate for PA elongation or compression at the branch level. This was observed during this analysis and has been confirmed by other studies [ 10 ].…”

Abnormal Pulmonary Artery Bending Correlates With Increased Right Ventricular Afterload Following the Arterial Switch Operation

“…13 These novel findings were found in both simple TGA variants and complex DORV variants. On the other hand, while the conventional measurements in our study were consistent with reported literature, 8,25 they only take into account PA stenosis and do not correlate with RV afterload. Our novel measurements ( R c , R c - w , and bending angle) quantify a phenomenon previously observed via angiography and described by Chen et al 26 and Chiu et al 27 as “narrowing of the pulmonary arch window.” The abnormal curvatures and bending angles in the branch pulmonary arteries are likely an effect from multiple geometrical components, particularly enlargement of prox-AscAo and a rightward MPA position.…”

Pulmonary, aorta, and coronary arteries post-arterial switch in transposition of great arteries: intermediate-term surveillance utilizing conventional echocardiography and cardiac multislice computed tomography

“…This could partly explain the small prevalence of LPA stenosis in our series. On the contrary, Morgan et al 's series included 83% rightward neo-pulmonary and only 5% direct anteroposterior arrangement with more frequency of LPA stenosis in their cohort [19]. Aortic root dilation was detected in 90% of the current series, aortic annulus dilatation in 80%, and STJ dilatation in 70%.…”

Quantification of Pulmonary Artery Configuration after the Arterial Switch Operation: A Pilot Study

“…The enlarged root creates a substrate for PA elongation or compression at the branch level. This was observed during this analysis and has been confirmed by other studies [ 10 ].…”

Abnormal Pulmonary Artery Bending Correlates With Increased Right Ventricular Afterload Following the Arterial Switch Operation

“…13 These novel findings were found in both simple TGA variants and complex DORV variants. On the other hand, while the conventional measurements in our study were consistent with reported literature, 8,25 they only take into account PA stenosis and do not correlate with RV afterload. Our novel measurements ( R c , R c - w , and bending angle) quantify a phenomenon previously observed via angiography and described by Chen et al 26 and Chiu et al 27 as “narrowing of the pulmonary arch window.” The abnormal curvatures and bending angles in the branch pulmonary arteries are likely an effect from multiple geometrical components, particularly enlargement of prox-AscAo and a rightward MPA position.…”

Pulmonary, aorta, and coronary arteries post-arterial switch in transposition of great arteries: intermediate-term surveillance utilizing conventional echocardiography and cardiac multislice computed tomography

“…This could partly explain the small prevalence of LPA stenosis in our series. On the contrary, Morgan et al 's series included 83% rightward neo-pulmonary and only 5% direct anteroposterior arrangement with more frequency of LPA stenosis in their cohort [19]. Aortic root dilation was detected in 90% of the current series, aortic annulus dilatation in 80%, and STJ dilatation in 70%.…”

Quantification of Pulmonary Artery Configuration after the Arterial Switch Operation: A Pilot Study

“…The enlarged root creates a substrate for PA elongation or compression at the branch level. This was observed during this analysis and has been confirmed by other studies [ 10 ].…”

Abnormal Pulmonary Artery Bending Correlates With Increased Right Ventricular Afterload Following the Arterial Switch Operation

“…13 These novel findings were found in both simple TGA variants and complex DORV variants. On the other hand, while the conventional measurements in our study were consistent with reported literature, 8,25 they only take into account PA stenosis and do not correlate with RV afterload. Our novel measurements ( R c , R c - w , and bending angle) quantify a phenomenon previously observed via angiography and described by Chen et al 26 and Chiu et al 27 as “narrowing of the pulmonary arch window.” The abnormal curvatures and bending angles in the branch pulmonary arteries are likely an effect from multiple geometrical components, particularly enlargement of prox-AscAo and a rightward MPA position.…”

Pulmonary, aorta, and coronary arteries post-arterial switch in transposition of great arteries: intermediate-term surveillance utilizing conventional echocardiography and cardiac multislice computed tomography

“…This could partly explain the small prevalence of LPA stenosis in our series. On the contrary, Morgan et al 's series included 83% rightward neo-pulmonary and only 5% direct anteroposterior arrangement with more frequency of LPA stenosis in their cohort [19]. Aortic root dilation was detected in 90% of the current series, aortic annulus dilatation in 80%, and STJ dilatation in 70%.…”