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Left ventricular function and exercise capacity after arterial switch operation for transposition of the great arteries: a systematic review and meta-analysis

Published online by Cambridge University Press:  31 May 2018

Sebastiaan W. van Wijk ,
Mieke M. Driessen ,
Folkert J. Meijboom ,
Pieter A. Doevendans ,
Paul H. Schoof ,
Hans M. Breur  and
Tim Takken
Sebastiaan W. van Wijk*
Affiliation:
Department of Paediatric Cardiology, Wilhelmina Children’s Hospital, University Medical Centre Utrecht, The Netherlands
Mieke M. Driessen
Affiliation:
Department of Cardiology, University Medical Centre Utrecht, The Netherlands
Folkert J. Meijboom
Affiliation:
Department of Paediatric Cardiology, Wilhelmina Children’s Hospital, University Medical Centre Utrecht, The Netherlands Department of Cardiology, University Medical Centre Utrecht, The Netherlands
Pieter A. Doevendans
Affiliation:
Department of Cardiology, University Medical Centre Utrecht, The Netherlands ICIN-Netherlands Heart Institute, Utrecht, The Netherlands
Paul H. Schoof
Affiliation:
Paediatric Cardiothoracic Surgery, Wilhelmina Children’s Hospital, University Medical Centre Utrecht, The Netherlands
Hans M. Breur
Affiliation:
Department of Paediatric Cardiology, Wilhelmina Children’s Hospital, University Medical Centre Utrecht, The Netherlands
Tim Takken
Affiliation:
Paediatric Clinical Exercise Physiology, Wilhelmina Children’s Hospital, University Medical Centre Utrecht, The Netherlands
*
Author for correspondence: S. W. van Wijk, Wilhelmina Children’s Hospital, Lundlaan 6, 3584 EA, Utrecht, The Netherlands. Tel: 088 755 5555; Fax: 088 755 5323; E-mail: W.H.S.vanWijk@umcutrecht.nl
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Abstract

Background

The arterial switch operation for transposition of the great arteries was initially believed to be an anatomical correction. Recent evidence shows reduced exercise capacity and left ventricular function in varying degrees in the long term after an arterial switch operation.

Objective

To perform a meta-analysis on long-term exercise capacity and left ventricular ejection fraction after an arterial switch operation.

Methods

A literature search was performed to cover all studies on patients who had undergone a minimum of 6 years of follow-up that reported either left ventricular ejection fraction, peak oxygen uptake, peak workload, and/or peak heart rate. A meta-analysis was performed if more than three studies reported the outcome of interest.

Results

A total of 21 studies reported on the outcomes of interest. Oxygen uptake was consistently lower in patients who had undergone an arterial switch operation compared with healthy controls, with a pooled average peak oxygen uptake of 87.5±2.9% of predicted. The peak heart rate was also lower compared with that of controls, at 92±2% of predicted. Peak workload was significantly reduced in two studies. Pooled left ventricular ejection fraction was normal at 60.7±7.2%.

Conclusion

Exercise capacity is reduced and left ventricular ejection fraction is preserved in the long term after an arterial switch operation for transposition of the great arteries.

Keywords

LVEFexercise capacityTGAtransposition of the great arteries
Type
Review Articles
Information
Cardiology in the Young , Volume 28 , Issue 7 , July 2018 , pp. 895 - 902
Copyright
© Cambridge University Press 2018 

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References

1. Jatene, AD, Fontes, VF, Spouza, LCB. Anatomic correction of transposition of the great arteries. J Thorac Cardiovasc Surg 1982; 83: 20–26.Google Scholar
2. Lecompte, Y, Neveux, JY, Leca, F, et al. Reconstruction of the pulmonary outflow tract without prosthetic conduit. J Thorac Cardiovasc Surg 1982; 84: 727–733.Google ScholarPubMed
3. Fricke, TA, d’Udekem, Y, Richardson, M, et al. Outcomes of the arterial switch operation for transposition of the great arteries: 25 years of experience. Ann Thorac Surg 2012; 94: 139–145.Google Scholar
4. Khairy, P, Clair, M, Fernandes, SM, et al. Cardiovascular outcomes after the arterial switch operation for D-transposition of the great arteries. Circulation 2013; 127: 331–339.Google Scholar
5. Oda, S, Nakano, T, Sugiura, J, Fusazaki, N, Ishikawa, S, Kado, H. Twenty-eight years’ experience of arterial switch operation for transposition of the great arteries in a single institution. Eur J Cardiothorac Surg 2012; 42: 674–679.Google Scholar
6. Jacobs, JP, Mavroudis, C, Quintessenza, JA, et al. Reoperations for pediatric and congenital heart disease: An analysis of the Society of Thoracic Surgeons (STS) congenital heart surgery database. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2014; 17: 2–8.Google Scholar
7. Haas, F, Wottke, M, Poppert, H, Meisner, H. Long-term survival and functional follow-up in patients after the arterial switch operation. Ann Thorac Surg 1999; 68: 1692–1697.Google Scholar
8. Hovels-Gurich, HH, Kunz, D, Seghaye, M, Miskova, M, Messmer, BJ, von Bernuth, G. Results of exercise testing at a mean age of 10 years after neonatal arterial switch operation. Acta Paediatr 2003; 92: 190–196.Google Scholar
9. Villafañe, J, Lantin-Hermoso, MR, Bhatt, AB, et al. D-Transposition of the great arteries. J Am Coll Cardiol 2014; 64: 498–511.Google Scholar
10. Pettersen, E, Fredriksen, PM, Urheim, S, et al. Ventricular function in patients with transposition of the great arteries operated with arterial switch. Am J Cardiol 2009; 104: 583–589.Google Scholar
11. Fredriksen, PM, Pettersen, E, Thaulow, E. Declining aerobic capacity of patients with arterial and atrial switch procedures. Pediatr Cardiol 2009; 30: 166–171.Google Scholar
12. Chen, RH, Wong, SJ, Wong, WH, Cheung, YF. Left ventricular contractile reserve after arterial switch operation for complete transposition of the great arteries: an exercise echocardiographic study. Eur Heart J Cardiovasc Imaging 2013; 14: 480–486.Google Scholar
13. Giardini, A, Khambadkone, S, Rizzo, N, et al. Determinants of exercise capacity after arterial switch operation for transposition of the great arteries. Am J Cardiol 2009; 104: 1007–1012.Google Scholar
14. Baggen, VJ, Driessen, MM, Meijboom, FJ, et al. Main pulmonary artery area limits exercise capacity in patients long-term after arterial switch operation. J Thorac Cardiovasc Surg 2015; 150: 918–925.Google Scholar
15. LeMura, LM, Von Duvillard, SP, Cohen, SL, et al. Treadmill and cycle ergometry testing in 5- to 6-year-old children. Eur J Appl Physiol 2001; 85: 472–478.Google Scholar
16. von Elm, E, Altman, DG, Egger, M, Pocock, SJ, Gøtzsche, PC, Vandenbroucke, JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Intern Med 2007; 147: 573–577.Google Scholar
17. da Costa, BR, Cevallos, M, Altman, DG, Rutjes, AWS, Egger, M. Uses and misuses of the STROBE statement: bibliographic study. BMJ Open 2011; 1: e000048.Google Scholar
18. Sanderson, S, Tatt, ID, Higgins, JP. Tools for assessing quality and susceptibility to bias in observational studies in epidemiology: a systematic review and annotated bibliography. Int J Epidemiol 2007; 36: 666–676.Google Scholar
19. Junge, C, Westhoff-bleck, M, Schoof, S, et al. Comparison of late results of arterial switch versus atrial switch (mustard procedure) operation for transposition of the great arteries. Am J Cardiol 2013; 111: 1505–1509.Google Scholar
20. de Koning, WB, van Osch-Gevers, M, Ten Harkel, AD, et al. Follow-up outcomes 10 years after arterial switch operation for transposition of the great arteries: comparison of cardiological health status and health-related quality of life to those of the a normal reference population. Eur J Pediatr 2008; 167: 995–1004.Google Scholar
21. Mahle, WT, Mcbride, MG, Paridon, SM. Exercise performance after the arterial switch operation for d-transposition of the great arteries. Am J Cardiol 2001; 87: 753–758.Google Scholar
22. Pasquali, SK, Marino, BS, McBride, MG, Wernovsky, G, Paridon, SM. Coronary artery pattern and age impact exercise performance late after the arterial switch operation. J Thorac Cardiovasc Surg 2007; 134: 1207–1212.Google Scholar
23. Sterrett, L, Schamberger, M, Ebenroth, E, Siddiqui, A, Hurwitz, R. Myocardial perfusion and exercise capacity 12 Years after arterial switch surgery for D-transposition of the great arteries. Pediatr Cardiol 2011; 32: 785–791.Google Scholar
24. Muller, J, Hess, J, Horer, J, Hager, A. Persistent superior exercise performance and quality of life long-term after arterial switch operation compared to that after atrial redirection. Int J Cardiol 2013; 166: 381–384.Google Scholar
25. Reybrouck, T, Eyskens, B, Mertens, L, Defoor, J, Daenen, W, Gewillig, M. Cardiorespiratory exercise function after the arterial switch operation for transposition of the great arteries. Eur Heart J 2001; 22: 1052–1059.Google Scholar
26. Tobler, D, Williams, WG, Jegatheeswaran, A, et al. Cardiac outcomes in young adult survivors of the arterial switch operation for transposition of the great arteries. J Am Coll Cardiol 2010; 56: 58–64.Google Scholar
27. van Beek, E, Binkhorst, M, de Hoog, M, et al. Exercise performance and activity level in children with transposition of the great arteries treated by the arterial switch operation. Am J Cardiol 2010; 105: 398–403.Google Scholar
28. Hui, L, Chau, AKT, Leung, MP, Chiu, CSW, Cheung, YF. Assessment of left ventricular function long term after arterial switch operation for transposition of the great arteries by dobutamine stress echocardiography. Heart 2005; 91: 68–72.Google Scholar
29. Kempny, A, Wustmann, K, Borgia, F, et al. Outcome in adult patients after arterial switch operation for transposition of the great arteries. Int J Cardiol 2013; 167: 2588–2593.Google Scholar
30. Kutty, S, Olson, J, Danford, CJ, et al. Ultrasound contrast and real-time perfusion in conjunction with supine bicycle stress echocardiography for comprehensive evaluation of surgically corrected congenital heart disease. Eur Heart J 2012; 13: 500–509.Google Scholar
31. Rodríguez Puras, MJ, Cabeza-Letrán, L, Romero-Vazquianez, M, et al. Mid-term morbidity and mortality of patients after arterial switch operation in infancy for transposition of the great arteries. Rev Esp Cardiol 2014; 67: 181–188.Google Scholar
32. Voges, I, Jerosch-Herold, M, Hedderich, J, et al. Implications of early aortic stiffening in patients with transposition of the great arteries after arterial switch operation. Circ imaging 2013; 6: 245–253.Google Scholar
33. Danias, PG, Chuang, ML, Parker, RA, et al. Relation between the number of image planes and the accuracy of three- dimensional echocardiography for measuring left ventricular volumes and ejection fraction. Am J Cardiol 1998; 82: 1431–1434.Google Scholar
34. Kempny, A, Dimopoulos, K, Uebing, A, et al. Reference values for exercise limitations among adults with congenital heart disease. Relation to activities of daily lifesingle centre experience and review of published data. Eur Heart J 2012; 33: 1386–1396.Google Scholar
35. Bengel, FM, Hauser, M, Duvernoy, CS, et al. Myocardial blood flow and coronary flow reserve late after anatomical correction of transposition of the great arteries. J Am Coll Cardiol 1998; 32: 1955–1961.Google Scholar
36. Hauser, M, Bengel, FM, Kühn, A, et al. Myocardial blood flow and flow reserve after coronary reimplantation in patients after arterial switch and ross operation. Circulation 2001; 103: 1875–1880.Google Scholar
37. Kuehn, A, Vogt, M, Schwaiger, M, Ewert, P, Hauser, M. Ventricular sympathetic innervation in patients with transposition of the great arteries after arterial switch operation and Rastelli procedure: impact of arterial dissection and coronary reimplantation. Circ J 2014; 78: 1717–1722.Google Scholar
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