title: The neoaortic root in children with transposition of the great arteries after an arterial switch operation.
abstract: OBJECTIVE
  Neoaortic root changes in children with transposition of the great arteries (TGA) are reportedly risk factors for the development of neoaortic regurgitation (NeoAR). The aims of this study were to assess the neoaortic root diameter and relative proportion in children with TGA after surgical correction and to identify possible correlations with the development of neoaortic insufficiency.
  
  
  METHODS
  Of the 611 children who had the arterial switch operation performed in the Cardiology Department of the Polish Mother's Memorial Hospital, 172 consecutive patients were qualified for this study. The inclusion criteria were: anatomical correction performed during the neonatal period, more than 10 years of postoperative observation and at least two full echocardiographic examinations.
  
  
  RESULTS
  NeoAR increased during postoperative follow-up and at the end of the observation period, 76% of the patients had NeoAR (27%-trace, 42%-mild, 7%-moderate and 0.6%-severe). Among the analysed risk factors for NeoAR development, the significant ones were arterial valve discrepancy (OR = 2.05; 95% CI: 1.04-4.02; P = 0.031) and the non-facing commissures (OR = 4.05; 95% CI: 1.34-11.9; P = 0.01). The neoaortic root diameter was not statistically significantly correlated with the presence of NeoAR or with the heart defects associated with transposition. The neoaortic root was initially, on average, 37% (z-score = 1.58) bigger than the aortic root in healthy children. This disproportion increased during the follow-up evaluations to 57% (z-score = 2.09).
  
  
  CONCLUSIONS
  The neoaortic root in children after the arterial switch procedure develops differently from that in healthy children, but this is not evidently related to NeoAR development or associated heart defects.
authors: Department of Cardiology and Cardiosurgery, Polish Mother's Memorial Hospital, Lodz, Poland. krzysiekmichalak@interia.pl
authors: Krzysztof W
authors: KW
authors: Michalak
authors: Jadwiga A
authors: JA
authors: Moll
authors: Maciej
authors: M
authors: Moll
authors: Pawel
authors: P
authors: Dryzek
authors: Tomasz
authors: T
authors: Moszura
authors: Marek
authors: M
authors: Kopala
authors: Katarzyna
authors: K
authors: Mludzik
authors: Jacek J
authors: JJ
authors: Moll
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D001011:Aorta / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D013504:Cardiovascular Surgical Procedures / Q000379:methods; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D008297:Male; D012307:Risk Factors; D014188:Transposition of Great Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*
keywords: Aortic insufficiency; Neoaortic valve; Root dilatation