1. Decreased clinical performance in TGA-ASO patients after RVOT interventions; a multicenter European collaboration.
- Author
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Engele, Leo J., González-Fernández, Víctor, Mulder, Barbara J.M., Ruperti-Repilado, Francisco Javier, Abia, Raquel Ladrón, van der Vlist, Kim, Buendía, Francisco, Rueda, Joaquin, Gabriel, Harald, Schrutka, Lore, Bouchardy, Judith, Schwerzmann, Markus, Possner, Mathias, Greutmann, Matthias, Gallego, Pastora, Ladouceur, Magalie, Jongbloed, Monique R.M., Tobler, Daniel, Dos, Laura, and Bouma, Berto J.
- Subjects
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VENTRICULAR outflow obstruction , *TRANSPOSITION of great vessels , *SYSTOLIC blood pressure , *AEROBIC capacity , *OXYGEN consumption - Abstract
In patients with transposition of the great arteries and an arterial switch operation (TGA-ASO) right ventricular outflow tract (RVOT) obstruction is a common complication requiring one or more RVOT interventions. We aimed to assess cardiopulmonary exercise capacity and right ventricular function in patients stratified for type of RVOT intervention. TGA-ASO patients (≥16 years) were stratified by type of RVOT intervention. The following outcome parameters were included: predicted (%) peak oxygen uptake (peak VO2), tricuspid annular plane systolic excursion (TAPSE), tricuspid Lateral Annular Systolic Velocity (TV S′), right ventricle (RV)-arterial coupling (defined as TAPSE/RV systolic pressure ratio), and N-terminal proBNP (NT-proBNP). 447 TGA patients with a mean age of 25.0 (interquartile range (IQR) 21–29) years were included. Patients without previous RVOT intervention (n = 338, 76%) had a significantly higher predicted peak VO2 (78.0 ± 17.4%) compared to patients with single approach catheter-based RVOT intervention (73.7 ± 12.7%), single approach surgical RVOT intervention (73.8 ± 28.1%), and patients with multiple approach RVOT intervention (66.2 ± 14.0%, p = 0.021). RV-arterial coupling was found to be significantly lower in patients with prior catheter-based and/or surgical RVOT intervention compared to patients without any RVOT intervention (p = 0.029). TGA patients after a successful arterial switch repair have a decreased exercise capacity. A considerable amount of TGA patients with either catheter or surgical RVOT intervention perform significantly worse compared to patients without RVOT interventions. • TGA patients after a successful arterial switch repair have a decreased exercise capacity. • Lower excercise capacity was seen in ASO patients after RVOT intervention compared to patients without RVOT intervention. • RV-arterial coupling emerged as the most sensitive hemodynamic parameter for RV performance after RVOT intervention. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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