Evaluation of cardiac and valvular function after arterial switch operation: a midterm follow-up.
OBJECTIVE
Transposition of Great Arteries (TGA) is a serious congenital heart disease and anatomic correction in the first few weeks of life has revealed good outcomes nowadays. In this study, we aimed to evaluate the myocardial and valvular function at midterm postoperative follow-up.


METHODS
In this study, thirty-three patients with TGA and Arterial Switch Operation (ASO) were evaluated by 2-dimensional, M-mode, Doppler, and pulsed Tissue Doppler. These patients were compared with 33 healthy children of the same age and gender as the normal control group. Student's t-test and Pearson correlation were used to analyze the data. Besides, P<0.05 was considered as statistically significant.


RESULTS
The mean follow up time was 40.9±5.6 months. Among the 33 patients with ASO, 6% had mild pulmonary stenosis, while 3% had mild pulmonary insufficiency. Aortic stenosis and aortic insufficiency of trivial to mild degree was seen in 12% and 12% of the patients, respectively. The patients' systolic velocity of tricuspid (S), early diastolic velocity of tricuspid (Ea), and late velocity of tricuspid valve (Aa) were significantly different from those of the controls (P<0.001). Also, pulmonary annulus diameter was significantly dilated in the patients compared to the controls (1.67±0.41 vs. 1.29±0.28, P≤0.001). Besides, aortic annulus diameter (1.56±0.42 vs. 1.24±0.21, P=0.001) and also aortic sinus diameter (2.06±0.41 vs. 1.44±0.34, P=0.002) were significantly dilated, while sinutuboar junction diameter (1.65±0.5 vs. 1.28±0.29, P=0.094) was not dilated. Left ventricular function was in the normal range.


CONCLUSIONS
This study showed good left ventricular function, but some abnormalities in lateral tricuspid tissue Doppler velocities. Neoaortic and pulmonary diameters were significantly dilated, while aortic and pulmonary insufficiencies were clinically insignificant in most of the patients. Long-term follow-up is necessary in these patients.
Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran ; Division of Pediatric Cardiology, Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, IR Iran.
Hamid
H
Amoozgar
Division of Pediatric Cardiology, Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, IR Iran.
Shirvan
S
Salaminia
Department of Cardiac Surgery, Shiraz University of Medical Sciences, Shiraz, IR Iran.
Ahmad Ali
AA
Amirghofran
Division of Pediatric Cardiology, Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, IR Iran.
Sirous
S
Cheriki
Division of Pediatric Cardiology, Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, IR Iran.
Mohammad
M
Borzoee
Division of Pediatric Cardiology, Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, IR Iran.
Gholamhossein
G
Ajami
Department of Pediatric, Islamic Azad University, Kazerun Branch, Kazerun, IR Iran.
Farah
F
Peiravian
Echocardiography; Follow-Up Studies; Heart Function Tests; Surgical Procedures; Switch; Transposition of Great Vessels