title: Neoaortic Valve Regurgitation After Arterial Switch: Ten Years Outcomes From A Single Center.
abstract: BACKGROUND
  Report results of neoaortic regurgitation (NAR) after arterial switch for patients with d-transposition of the great arteries (d-TGA) and corrected transposition of the great arteries.
  
  
  METHODS
  From 2003 to 2013, 583 patients who underwent arterial switch operation for d-TGA and 31 patients who underwent double switch (DS) for congenitally corrected transposition of the great arteries (cc-TGA) were included in this retrospective study. Since 2011, concomitant neoaortic sinotubular junction reconstruction was performed if aorta and pulmonary artery discrepancy was present in patients with d-TGA.
  
  
  RESULTS
  The long-term survival rate was 92.5% (544/583) in patients with d-TGA and 74.2% (23/31) in patients with cc-TGA. More NAR developed in patients with cc-TGA than with d-TGA. Moreover, significant NAR (7.1% [38/539] versus 26.1% [(6/23], p = 0.010) and the aortic valve replacement (0.6% [3/539] versus 8.7% [2/23], p = 0.003) were less in the d-TGA group. Previous pulmonary artery banding and aortic and pulmonary artery diameter discrepancy were identified as risk factors for significant NAR in patients with d-TGA. However, no specific risk factors were identified in patients with cc-TGA. With the application of neoaortic sinotubular junction reconstruction, no significant NAR was recorded in patients with aortic and pulmonary artery discrepancy.
  
  
  CONCLUSIONS
  After an arterial switch operation, we report a favorable incidence of NAR and rare neoaortic valve replacement. Significant NAR was associated with aorta-pulmonary discrepancy and previous pulmonary artery banding. Patients with cc-TGA may require close monitoring. Patients with aortic and pulmonary artery diameter discrepancy may benefit from sinotubular junction reconstruction.
authors.affiliation: Pediatric Cardiac Surgery Center, National Center for Cardiovascular Disease and Fuwai Hospital, CAMS and PUMC, Beijing, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Ma
authors.affiliation: Pediatric Cardiac Surgery Center, National Center for Cardiovascular Disease and Fuwai Hospital, CAMS and PUMC, Beijing, China. Electronic address: drlishoujun@yahoo.com.
authors.forename: Shoujun
authors.initials: S
authors.lastname: Li
authors.affiliation: Pediatric Cardiac Surgery Center, National Center for Cardiovascular Disease and Fuwai Hospital, CAMS and PUMC, Beijing, China.
authors.forename: Shengshou
authors.initials: S
authors.lastname: Hu
authors.affiliation: Pediatric Cardiac Surgery Center, National Center for Cardiovascular Disease and Fuwai Hospital, CAMS and PUMC, Beijing, China.
authors.forename: Zhongdong
authors.initials: Z
authors.lastname: Hua
authors.affiliation: Pediatric Cardiac Surgery Center, National Center for Cardiovascular Disease and Fuwai Hospital, CAMS and PUMC, Beijing, China.
authors.forename: Keming
authors.initials: K
authors.lastname: Yang
authors.affiliation: Pediatric Cardiac Surgery Center, National Center for Cardiovascular Disease and Fuwai Hospital, CAMS and PUMC, Beijing, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Yan
authors.affiliation: Pediatric Cardiac Surgery Center, National Center for Cardiovascular Disease and Fuwai Hospital, CAMS and PUMC, Beijing, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Pediatric Cardiac Surgery Center, National Center for Cardiovascular Disease and Fuwai Hospital, CAMS and PUMC, Beijing, China.
authors.forename: Qiuming
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Pediatric Cardiac Surgery Center, National Center for Cardiovascular Disease and Fuwai Hospital, CAMS and PUMC, Beijing, China.
authors.forename: Sen
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Pediatric Cardiac Surgery Center, National Center for Cardiovascular Disease and Fuwai Hospital, CAMS and PUMC, Beijing, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Qi
mesh_terms: D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014188:Transposition of Great Vessels / Q000601:surgery*; D016896:Treatment Outcome