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Coronary Artery Aneurysms Following Repair of Transposition of the Great Arteries.

ABSTRACT:

SUBMITTER: Das N

PROVIDER: S-EPMC10954681 | biostudies-literature | 2024 Mar

REPOSITORIES: biostudies-literature

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Coronary Artery Aneurysms Following Repair of Transposition of the Great Arteries.

Das Nikkan N Husain Nazia N Puthumana Jyothy J JJ Carr Michael R MR Patel Shivani G SG

CASE (Philadelphia, Pa.) 20240308 3Part A

PMID: 38524973

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Project description:BackgroundPulmonary artery (PA) stenosis is common after arterial switch operation (ASO) for transposition of the great arteries (TGA). Differences between balloon angioplasty (BA) and stents on right ventricular (RV) and PA pressures are not well studied.ObjectivesThe purpose of this study was to analyze percutaneous PA interventions' frequency after ASO, complications, and the effects of BA and stents on RV and PA pressures.MethodsAll TGA patients with ASO between 1977 and 2022 in 2 Dutch congenital heart centers were included in this multicenter retrospective study. Peri-operative ASO characteristics and pre-intervention and post-intervention invasive and echocardiographic data were analyzed.ResultsASO was performed in 960 TGA patients, of which 888 survived 30 days and had complete follow-up. Seventy-seven (9%) underwent percutaneous PA interventions. Taussig-Bing anomaly (OR: 2.8; 95% CI: 1.228-6.168; P = 0.014), ASO time era 1990 to 1999 (OR: 4.7; 95% CI: 1.762-12.780; P = 0.002), and 2000 to 2009 (OR: 4.3; 95% CI: 1.618-11.330; P = 0.003) were independently associated with percutaneous PA interventions after ASO. Invasive post-interventional pressures and gradients were lower after stent implantation compared to BA (RV pressure: 47 ± 14 vs 58 ± 11; right PA-PA gradient: 11 ± 11 vs 25 ± 12, P < 0.05; RV/left ventricle pressure ratio: 0.4 ± 0.1 vs 0.6 ± 0.2, P < 0.001). Of the patients with unilateral PA stenosis (left PA: 41%, right PA: 59%), 77% showed increased RV pressure (>30 mm Hg) and RV/left ventricle pressure ratio improved post-intervention (0.5 ± 0.2 vs 0.6 ± 0.2, P < 0.05). Seventeen complications, most minor, were reported (13%). Two post-procedural deaths were reported.ConclusionsPercutaneous PA interventions are common after ASO and can be performed safely but caution for serious complications is warranted. Unilateral PA stenosis can impact RV pressures. Stents may be more successful at treating PA stenosis compared to BA.

Dataset Information

Coronary Artery Aneurysms Following Repair of Transposition of the Great Arteries.

Publications

Coronary Artery Aneurysms Following Repair of Transposition of the Great Arteries.

Similar Datasets

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