%0 Journal Article
%T Clinical Course of TGA After Arterial Switch Operation in the Current Era.
%A Engele LJ
%A van der Palen RLF
%A Joosen RS
%A Sieswerda GT
%A Schoof PH
%A van Melle JP
%A Berger RMF
%A Accord RE
%A Rammeloo LAJ
%A Konings TC
%A Helbing WA
%A Roos-Hesselink JW
%A van de Woestijne PC
%A Frerich S
%A van Dijk APJ
%A Kuipers IM
%A Hazekamp MGH
%A Mulder BJM
%A Breur JMPJ
%A Blom N
%A Jongbloed MRM
%A Bouma BJ
%J JACC Adv
%V 3
%N 2
%D 2024 Feb
%M 38939383
暂无%R 10.1016/j.jacadv.2023.100772
%X <B>UNASSIGNED: </B>The number of patients with an arterial switch operation (ASO) for transposition of the great arteries (TGA) is steadily growing; limited information is available regarding the clinical course in the current era.<BR><B>UNASSIGNED: </B>The purpose was to describe clinical outcome late after ASO in a national cohort, including survival, rates of (re-)interventions, and clinical events.<BR><B>UNASSIGNED: </B>A total of 1,061 TGA-ASO patients (median age 10.7 years [IQR: 2.0-18.2 years]) from a nationwide prospective registry with a median follow-up of 8.0 years (IQR: 5.4-8.8 years) were included. Using an analysis with age as the primary time scale, cumulative incidence of survival, (re)interventions, and clinical events were determined.<BR><B>UNASSIGNED: </B>At the age of 35 years, late survival was 93% (95% CI: 88%-98%). The cumulative re-intervention rate at the right ventricular outflow tract and pulmonary branches was 36% (95% CI: 31%-41%). Other cumulative re-intervention rates at 35 years were on the left ventricular outflow tract (neo-aortic root and valve) 16% (95% CI: 10%-22%), aortic arch 9% (95% CI: 5%-13%), and coronary arteries 3% (95% CI: 1%-6%). Furthermore, 11% (95% CI: 6%-16%) of the patients required electrophysiological interventions. Clinical events, including heart failure, endocarditis, and myocardial infarction occurred in 8% (95% CI: 5%-11%). Independent risk factors for any (re-)intervention were TGA morphological subtype (Taussig-Bing double outlet right ventricle [HR: 4.9, 95% CI: 2.9-8.1]) and previous pulmonary artery banding (HR: 1.6, 95% CI: 1.0-2.2).<BR><B>UNASSIGNED: </B>TGA-ASO patients have an excellent survival. However, their clinical course is characterized by an ongoing need for (re-)interventions, especially on the right ventricular outflow tract and the left ventricular outflow tract indicating a strict lifelong surveillance, also in adulthood.