Features of the right atrium in repaired dextro-transposition of the great arteries following atrial switch operations (Insights from the CSONGRAD Registry and MAGYAR-Path Study)

Background: In dextro-transposition of the great arteries (dTGA), the aorta and the pulmonary artery are transposed. The present study aimed a three-dimensional speckle-tracking echocardiography-derived determination of volumetric and functional features of the atrium being on the morphologic right side [‘right atrium (RA)] in adult patients with dTGA. Methods: The present study comprised 18 adult dTGA patients, four of whom were excluded due to inferior image quality. From the remaining 14 patients (mean age: 29.7 ± 8.1 years, 9 males), 7 cases underwent Mustard-procedure, while another 7 subjects underwent Senning-procedure. Their results were compared to that of 28 age- and gender-matched healthy subjects (28.8 ± 1.4 years, 20 males). Results: Increased RA volumes respecting the cardiac cycle could be demonstrated in dTGA patients compared to controls. RA stroke volumes (SVs) for reservoir and conduit function were reduced together with impaired RA emptying fractions (EFs) featuring all phases of RA function. Mustard-operated patients showed tendentiously lower RA volumes and increased SVs and EFs respecting the cardiac cycle compared to those of Senning-operated patients suggesting beneficial results for Mustard-procedure. Reduced RA global and mean segmental peak RA strains and RA strains at atrial contraction could be detected in dTGA patients compared to those of controls with tendentiously lower values in Mustard-operated patients compared to those of Senning-operated subjects. Conclusions: Significant RA volumetric and functional abnormalities could be detected in adult dTGA patients following atrial switch repair. While RA volumetric data proved to be better in Mustard-operated patients, RA strains were enhanced in Senning-operated subjects.