Clinical Report: LV Function Mostly Preserved After ASO
Overview
A retrospective study found that most patients with d-transposition of the great arteries who underwent arterial switch operation had preserved left ventricular function. Cardiac magnetic resonance imaging revealed a median left ventricular ejection fraction of 60%, with only 17% of patients showing reduced function.
Background
D-transposition of the great arteries (d-TGA) is a congenital heart defect that requires surgical intervention, typically the arterial switch operation (ASO). This study contributes to the evidence regarding the cardiac health of individuals who have undergone ASO.
Data Highlights
| Parameter | Value |
|---|---|
| Median Age at CMR | 14.3 years |
| Median LVEF | 60% |
| Reduced LVEF (<55%) | 17% |
| Median Adult 2D Global Longitudinal Strain | 18.1% |
| Median Pediatric 2D Global Longitudinal Strain | 20.4% |
Key Findings
- Most patients had preserved left ventricular systolic function post-ASO.
- Median left ventricular ejection fraction (LVEF) was 60%.
- Only 17% of patients had reduced LVEF, with no cases of severe systolic dysfunction.
- Neoaortic regurgitation was generally mild, with 19 patients showing no regurgitation.
- Late gadolinium enhancement (LGE) was present in 9.6% of patients, indicating potential myocardial scar tissue.
Clinical Implications
The findings suggest that cardiac magnetic resonance imaging can be a valuable tool for assessing left ventricular function and neoaortic valve status in patients post-ASO. Clinicians should consider regular imaging to monitor for potential complications, including myocardial scarring.
Conclusion
Overall, the study indicates that left ventricular function remains preserved in the majority of patients following arterial switch operation, highlighting the importance of ongoing surveillance as these patients age.
Related Resources & Content
- Joshi K, et al., Annals of Pediatric Cardiology, 2023 -- LV Function Mostly Preserved After ASO
- Pediatric Cardiology, 2021 -- The Relationship Between Oxygen Uptake Efficiency Slope and VO2peak in Patients Long-Term Following Arterial Switch Surgery
- Pediatric Cardiology, 2018 -- Long-Term Assessment of Left Ventricular Performance Following Arterial Switch Surgery for Great Artery Transposition
- 2025 ACC/AHA/HRS/ISACHD/SCAI Guideline for the Management of Adults With Congenital Heart Disease
- Clinical Research in Cardiology — Elderly patients with paradoxical low-flow, low-gradient aortic stenosis experience the least improvement from TAVI compared to other hemodynamic categories.
- Pediatric Cardiology — The Role of Routine Coronary CT Angiography in Assessing Patients with Transposition of the Great Arteries Post-Arterial Switch Operation
- 2025 ACC/AHA/HRS/ISACHD/SCAI Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines | JACC
- Long-term outcomes of the arterial switch operation - PubMed
- Cardiac magnetic resonance features of the left ventricle in d-transposition of the great arteries after arterial switch operation: Results from a single center - PMC
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