Long-term quality of life in adult survivors after the arterial switch operation

Objective: The goal of the study was to evaluate the quality of life of children after the older corrective arterial switch operation (ASO) by means of the Pediatric Quality of Life Inventory (PedsQL), version 4.0.Methods: The records of 86 patients who had complete transposition of the great arteries plus a nonrestrictive ventricular septal defect, or a Taussig-Bing anomaly, and severe pulmonary arterial hypertension, and who underwent a corrective ASO at an older age (>6 months) between May 2000 and October 2008 were reviewed retrospectively. Eighty survivors were followed up, and the health-related quality of life of the survivors was evaluated with the PedsQL, version 4.0.Results: There were 6 hospital deaths. The mean (SD) follow-up interval was 3.5 � 2.3 years, and the mean age at last visit was 7.0 � 1.2 years. Two late deaths occurred, and 8 patients were lost to follow-up. Patients who underwent a corrective ASO at an older age showed acceptable scores for all scales, and they were all comparable with those of a healthy population.Conclusions: Our data suggest that the quality of life of children who undergo a corrective ASO at an older age (>6 months) is acceptable, compared with that of healthy children in China.

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Complications in the long-term period after the arterial switch operation

CHILDREN’S HEART AND VASCULAR DISEASES ◽

10.24022/1810-0686-2018-15-2-69-75 ◽

2018 ◽

Vol 15 (2) ◽

pp. 69-75

Author(s):

I.E. Nefedova

Keyword(s):

Arterial Switch Operation ◽

Arterial Switch ◽

Switch Operation

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Factors Affecting Health-Related Quality of Life After the Arterial Switch Operation

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/2150135121990651 ◽

2021 ◽

Vol 12 (3) ◽

pp. 344-351

Author(s):

Julie Cleuziou ◽

Anna-Katharina Huber ◽

Martina Strbad ◽

Masamichi Ono ◽

Alfred Hager ◽

...

Keyword(s):

Quality Of Life ◽

Short Form ◽

Arterial Switch Operation ◽

Health Related Quality ◽

Switch Operation ◽

Sf 36 ◽

Related Quality ◽

Health Related ◽

Cardiac Medication

Background: Long-term morbidity and mortality outcomes of the arterial switch operation (ASO) in patients with transposition of the great arteries and Taussig-Bing anomaly are excellent. With an increasing number of patients reaching adolescence and adulthood, more attention is directed toward quality of life. Our study aimed to determine the health-related quality of life (hrQoL) outcomes in patients after the ASO and identify factors influencing their hrQoL. Methods: In this cross-sectional study, hrQoL of patients after ASO was assessed with the German version of the Short Form-36 (SF-36) and the potential association of specified clinical factors was analyzed. Patients of at least 14 years of age who underwent ASO in our institution from 1983 were considered eligible. Results: Of the 355 questionnaires sent to eligible patients, 261 (73%) were available for analysis. Compared to the reference population, patients who had undergone ASO had a significantly higher score in all subscales of the SF-36 except for vitality ( P < .01). Patients with an implanted pacemaker ( P = .002), patients who required at least one reoperation ( P < .001), and patients currently taking cardiac medication ( P < .004) or oral anticoagulation ( P = .036) had lower physical component scores compared to patients without these factors. Conclusions: Patients’ self-assessed and self-reported hrQoL after ASO (using German version of the Short Form 36) is very good. In this population, hrQoL is influenced by reoperation, the need for a pacemaker, and current cardiac medication or anticoagulant use. The development of strategies designed to mitigate or minimize the requirements for, and/or impact of these factors may lead to better hrQoL in this patient population.

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Single coronary artery and neonatal arterial switch operation: early and long-term outcomes†

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezx046 ◽

2017 ◽

Vol 52 (1) ◽

pp. 90-95 ◽

Cited By ~ 7

Author(s):

Sébastien Gerelli ◽

Margaux Pontailler ◽

Bruno Rochas ◽

Emanuela Angeli ◽

Mathieu Van Steenberghe ◽

...

Keyword(s):

Coronary Artery ◽

Arterial Switch Operation ◽

Single Coronary Artery ◽

Long Term Outcomes ◽

Arterial Switch ◽

Switch Operation

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Abstract 14744: Native Bicuspid Pulmonary Valve in D-loop Transposition of the Great Arteries: Outcomes of the Neo-aortic Valve Function and Root Dilation After Arterial Switch Operation

Circulation ◽

10.1161/circ.142.suppl_3.14744 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Jane Margaret Irwin ◽

Geoffrey Binney ◽

Kimberlee Gauvreau ◽

Sitaram Emani ◽

Elizabeth Blume ◽

...

Keyword(s):

Aortic Valve ◽

Pulmonary Valve ◽

Arterial Switch Operation ◽

Arterial Switch ◽

Switch Operation ◽

Significant Difference ◽

First Occurrence ◽

D Loop

Introduction: Neo-aortic root dilation (ARD) is common after arterial switch operation (ASO) for D-loop transposition of the great arteries (TGA). We sought to compare short and long-term outcomes for bicuspid native pulmonary valve (BNPV) patients to those with normal trileaflet variants (TNPV). Methods: A retrospective cohort of TGA patients undergoing ASO at Boston Children’s Hospital from 1989-2018 was analyzed, matching BNPV patients 1:3 with TNPV patients by year of ASO; those with >mild subpulmonary stenosis or complex TGA were excluded. Categorical and continuous variables were compared using Fisher’s exact and Wilcoxon rank sum tests, respectively. Kaplan-Meier analyses with log-rank test compared groups for time to first reoperation on the neo-aortic valve, first occurrence of ≥moderate neo-aortic regurgitation (AR), and ARD defined as root z-score ≥4. Hazard ratios were estimated based on the Cox proportional hazards model. Results: A total of 83 BNPV patients were matched with 217 TNPV. BNPV patients were more likely to have a VSD (75% vs 44%, p <0.001). Early surgical outcomes including hospital LOS (11 vs 10 days) and 30-day mortality (3.6% vs 2.8%) were similar. During median 10 years follow-up, neo-aortic valve reoperation occurred in 4 BNPV (6%) vs 6 TNPV (3%) patients, with no statistically significant difference in time to reoperation. More BNPV patients had AR at discharge (4.9% vs 0%, p=0.014) and during follow-up (13.4% vs 4.3%, HR 3.9, p=0.004), with shorter time to first occurrence of AR (Figure 1A); this remained significant after adjusting for presence of VSD. Similarly, ARD was more common in BNPV (45% vs 37%, HR 1.64, p=0.02) with shorter time to first occurrence (Figure 1B). Conclusions: While patients with BNPV have similar short-term ASO outcomes, AR and ARD occur more frequently and earlier compared with TNPV patients. Further long-term studies are needed to determine whether this results in greater need for neo-aortic valve reoperation.

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