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Is the function of all cardiac valves after the arterial switch operation influenced by an associated ventricular septal defect?

Published online by Cambridge University Press:  15 February 2011

J. Gabriel ,
H.-H. Scheld ,
T.D.T. Tjan ,
N. Osada  and
Thomas Krasemann
J. Gabriel
Affiliation:
Department of Thoracic and Cardiovascular Surgery, University Hospital Muenster, Albert-Schweitzer-Strasse, Muenster, Germany
H.-H. Scheld
Affiliation:
Department of Thoracic and Cardiovascular Surgery, University Hospital Muenster, Albert-Schweitzer-Strasse, Muenster, Germany
T.D.T. Tjan
Affiliation:
Department of Thoracic and Cardiovascular Surgery, University Hospital Muenster, Albert-Schweitzer-Strasse, Muenster, Germany
N. Osada
Affiliation:
Department of Medical Informatics and Biomathematics, University of Muenster, Einsteinstrasse, Muenster, Germany
Thomas Krasemann*
Affiliation:
Department of Paediatric Cardiology, Evelina Children's Hospital London, Guy's & St Thomas NHS Foundation Trust, London, United Kingdom
*
Correspondence to: T. Krasemann, Consultant Paediatric Cardiologist, Evelina Children's Hospital, Guy's & St Thomas NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, United Kingdom. Tel: 44 207 1884562; Fax: 44 207 1884556; E-mail: Thomas.krasemann@gstt.nhs.uk
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Abstract

A ventricular septal defect in transposition of the great arteries is frequently closely related to the cardiac valves. The valvar function after arterial switch operation of patients with transposition of the great arteries and ventricular septal defect or intact ventricular septum was compared. We analysed the function of all cardiac valves in patients who underwent the arterial switch operations pre- and post-operatively, 1 year after the procedure and on follow-up. The study included 92 patients – 64 with transposition of the great arteries/intact ventricular septum and 28 with transposition of the great arteries/ventricular septal defect. The median age at surgery was 5.5 days in transposition of the great arteries/intact ventricular septum (0–73 days) and 7.0 days in transposition of the great arteries/ventricular septal defect (4–41 days). Follow-up was 51.7 months in transposition of the great arteries/intact ventricular septum (3.3–177.3 months) and 55 months in transposition of the great arteries/ventricular septal defect (14.6–164.7 months). Neo-aortic, neo-pulmonary, and mitral valvar function did not differ. Tricuspid regurgitation was more frequent 1 year post-operatively in transposition of the great arteries/ventricular septal defect (n = 4) than in transposition of the great arteries/intact ventricular septum. The prevalence of neo-aortic regurgitation and pulmonary stenosis increased over time, especially in patients with transposition of the great arteries/intact ventricular septum. The presence of a ventricular septal defect in patients undergoing arterial switch operation for transposition of the great arteries only has a minor bearing for the development of valvar dysfunction on the longer follow-up.

Keywords

Transposition of the great arteriesarterial switchvalvar function
Type
Original Articles
Information
Cardiology in the Young , Volume 21 , Issue 4 , 12 July 2011 , pp. 383 - 391
Copyright
Copyright © Cambridge University Press 2011

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