Details

Autor(en) / Beteiligte

• Broberg, Craig S.
• van Dissel, Alexandra C.
• Minnier, Jessica
• Aboulhosn, Jamil
• Kauling, Robert M.
• Ginde, Salil
• Krieger, Eric V.
• Rodriguez, Fred
• Gupta, Tripti
• Shah, Sangeeta
• John, Anitha S.
• Cotts, Timothy
• Kay, W. Aaron
• Kuo, Marissa
• Dwight, Cindy
• Woods, Patricia
• Nicolarsen, Jeremy
• Sarubbi, Berardo
• Fusco, Flavia
• Antonova, Petra
• Fernandes, Susan
• Grewal, Jasmine
• Cramer, Jonathan
• Khairy, Paul
• Gallego, Pastora
• O’Donnell, Clare
• Hannah, Jane
• Dellborg, Mikael
• Rodriguez-Monserrate, Carla P.
• Muhll, Isabelle Vonder
• Pylypchuk, Stephen
• Magalski, Anthony
• Han, Frank
• Lubert, Adam M.
• Kay, Joseph
• Yeung, Elizabeth
• Roos-Hesselink, Jolien
• Baker, David
• Celermajer, David S.
• Burchill, Luke J.
• Wilson, William M.
• Wong, Joshua
• Kutty, Shelby
• Opotowsky, Alexander R.

Titel

Long-Term Outcomes After Atrial Switch Operation for Transposition of the Great Arteries

Ist Teil von

• Journal of the American College of Cardiology, 2022-09, Vol.80 (10), p.951-963

Ort / Verlag

Elsevier Inc

Erscheinungsjahr

2022

Quelle

Access via ScienceDirect (Elsevier)

Beschreibungen/Notizen

• For patients with d-loop transposition of the great arteries (d-TGA) with a systemic right ventricle after an atrial switch operation, there is a need to identify risks for end-stage heart failure outcomes. The authors aimed to determine factors associated with survival in a large cohort of such individuals. This multicenter, retrospective cohort study included adults with d-TGA and prior atrial switch surgery seen at a congenital heart center. Clinical data from initial and most recent visits were obtained. The composite primary outcome was death, transplantation, or mechanical circulatory support (MCS). From 1,168 patients (38% female, age at first visit 29 ± 7.2 years) during a median 9.2 years of follow-up, 91 (8.8% per 10 person-years) met the outcome (66 deaths, 19 transplantations, 6 MCS). Patients experiencing sudden/arrhythmic death were younger than those dying of other causes (32.6 ± 6.4 years vs 42.4 ± 6.8 years; P < 0.001). There was a long duration between sentinel clinical events and end-stage heart failure. Age, atrial arrhythmia, pacemaker, biventricular enlargement, systolic dysfunction, and tricuspid regurgitation were all associated with the primary outcome. Independent 5-year predictors of primary outcome were prior ventricular arrhythmia, heart failure admission, complex anatomy, QRS duration >120 ms, and severe right ventricle dysfunction based on echocardiography. For most adults with d-TGA after atrial switch, progress to end-stage heart failure or death is slow. A simplified prediction score for 5-year adverse outcome is derived to help identify those at greatest risk. [Display omitted]