Skip to main content
Erschienen in: Heart and Vessels 5/2021

27.11.2020 | Original Article

Predictors of neo-aortic valve regurgitation in the long term after arterial switch operation

verfasst von: Takuma Takada, Seiji Asagai, Masaki Sato, Gen Harada, Eriko Shimada, Mikiko Ishido, Tokuko Shinohara, Kei Inai, Nobuhisa Hagiwara

Erschienen in: Heart and Vessels | Ausgabe 5/2021

Einloggen, um Zugang zu erhalten

Abstract

Although arterial switch operations (ASOs) have been performed globally to repair d-transposition of the great arteries (d-TGA) in neonates and infants, few studies have been reported regarding the influence of the hemodynamics of patients with d-TGA who have undergone ASO on the development of neo-aortic valve regurgitation (AR). We aimed to investigate the relationship between the hemodynamics and development of AR after ASO in patients with d-TGA by catheter evaluation. This observational study screened 114 consecutive patients who underwent ASO for d-TGA or Taussig–Bing anomaly and who subsequently underwent catheter evaluations in our institution. We reviewed their records for the past 20 years and collected their first catheterization data post-ASO in early childhood. Thirty-six post-ASO patients who underwent catheter evaluations in both the early surgical and long-term phases were finally analyzed. Patients were divided into the following groups according to the presence of significant AR in the long-term phase: the AR group (n = 9 with AR ≥ grade II by the Sellers classification) and the non-AR group (n = 27 with AR < grade II). In the long-term phase, the diastolic blood pressure was significantly lower and the ascending aortic diameter was significantly larger in the AR group than in the non-AR group (p = 0.004 and p = 0.006, respectively). The systolic blood pressure (SBP) and pulse pressure (PP) were similar in both groups. Meanwhile, in the early surgical phase, SBP and PP were significantly higher in the AR group than in the non-AR group (p = 0.029 and p = 0.002, respectively). The receiver operating characteristic curve for late AR showed that the area under the curve for SBP and PP in the early surgical phase were 0.746 and 0.853, respectively. Even though sensitivity analysis was performed, SBP or PP greater than the cutoff value in the early surgical phase was identified as predictors for late AR. Our results suggested that high SBP or PP in the early surgical phase could influence the development of AR in the long term after ASO.
Literatur
1.
Zurück zum Zitat Jatene AD, Fontes VF, Paulista PP, Souza LC, Neger F, Galantier M, Sousa JE (1976) Anatomic correction of transposition of the great vessels. J Thorac Cardiovasc Surg 72:364–370CrossRef Jatene AD, Fontes VF, Paulista PP, Souza LC, Neger F, Galantier M, Sousa JE (1976) Anatomic correction of transposition of the great vessels. J Thorac Cardiovasc Surg 72:364–370CrossRef
2.
Zurück zum Zitat Voges I, Jerosch-Herold M, Hedderich J, Hart C, Petko C, Scheewe J, Andrade AC, Pham M, Gabbert D, Kramer HH, Rickers C (2013) Implications of early aortic stiffening in patients with transposition of the great arteries after arterial switch operation. Circ Cardiovasc Imaging 6:245–253CrossRef Voges I, Jerosch-Herold M, Hedderich J, Hart C, Petko C, Scheewe J, Andrade AC, Pham M, Gabbert D, Kramer HH, Rickers C (2013) Implications of early aortic stiffening in patients with transposition of the great arteries after arterial switch operation. Circ Cardiovasc Imaging 6:245–253CrossRef
3.
Zurück zum Zitat Tobler D, Williams WG, Jegatheeswaran A, Van Arsdell GS, McCrindle BW, Greutmann M, Oechslin EN, Silversides CK (2010) Cardiac outcomes in young adult survivors of the arterial switch operation for transposition of the great arteries. J Am Coll Cardiol 56:58–64CrossRef Tobler D, Williams WG, Jegatheeswaran A, Van Arsdell GS, McCrindle BW, Greutmann M, Oechslin EN, Silversides CK (2010) Cardiac outcomes in young adult survivors of the arterial switch operation for transposition of the great arteries. J Am Coll Cardiol 56:58–64CrossRef
4.
Zurück zum Zitat Sugiyama H, Tsuda E, Ohuchi H, Yamada O, Shiraishi I (2016) Chronological changes in stenosis of translocated coronary arteries on angiography after the arterial switch operation in children with transposition of the great arteries: comparison of myocardial scintigraphy and angiographic findings. Cardiol Young 26:638–643CrossRef Sugiyama H, Tsuda E, Ohuchi H, Yamada O, Shiraishi I (2016) Chronological changes in stenosis of translocated coronary arteries on angiography after the arterial switch operation in children with transposition of the great arteries: comparison of myocardial scintigraphy and angiographic findings. Cardiol Young 26:638–643CrossRef
5.
Zurück zum Zitat Warnes CA (2006) Transposition of the great arteries. Circulation 114:2699–2709CrossRef Warnes CA (2006) Transposition of the great arteries. Circulation 114:2699–2709CrossRef
6.
Zurück zum Zitat Hourihan M, Colan SD, Wernovsky G, Maheswari U, Mayer JE Jr, Sanders SP (1993) Growth of the aortic anastomosis, annulus, and root after the arterial switch procedure performed in infancy. Circulation 88:615–620CrossRef Hourihan M, Colan SD, Wernovsky G, Maheswari U, Mayer JE Jr, Sanders SP (1993) Growth of the aortic anastomosis, annulus, and root after the arterial switch procedure performed in infancy. Circulation 88:615–620CrossRef
7.
Zurück zum Zitat Nakayama Y, Tsumura K, Yamashita N, Yoshimaru K, Hayashi T (2000) Pulsatility of ascending aortic pressure waveform is a powerful predictor of restenosis after percutaneous transluminal coronary angioplasty. Circulation 101:470–472CrossRef Nakayama Y, Tsumura K, Yamashita N, Yoshimaru K, Hayashi T (2000) Pulsatility of ascending aortic pressure waveform is a powerful predictor of restenosis after percutaneous transluminal coronary angioplasty. Circulation 101:470–472CrossRef
8.
Zurück zum Zitat Agnoletti G, Ou P, Celermajer DS, Boudjemline Y, Marini D, Bonnet D, Aggoun Y (2008) Acute angulation of the aortic arch predisposes a patient to ascending aortic dilatation and aortic regurgitation late after the arterial switch operation for transposition of the great arteries. J Thorac Cardiovasc Surg 135:568–572CrossRef Agnoletti G, Ou P, Celermajer DS, Boudjemline Y, Marini D, Bonnet D, Aggoun Y (2008) Acute angulation of the aortic arch predisposes a patient to ascending aortic dilatation and aortic regurgitation late after the arterial switch operation for transposition of the great arteries. J Thorac Cardiovasc Surg 135:568–572CrossRef
9.
Zurück zum Zitat Sellers RD, Levy MJ, Kurt Amplatz C, Lillehei W (1964) Left retrograde cardioangiography in acquired cardiac disease: technic, indications and interpretations in 700 cases. Am J Cardiol 14:437–447CrossRef Sellers RD, Levy MJ, Kurt Amplatz C, Lillehei W (1964) Left retrograde cardioangiography in acquired cardiac disease: technic, indications and interpretations in 700 cases. Am J Cardiol 14:437–447CrossRef
10.
Zurück zum Zitat Schwartz ML, Gauvreau K, del Nido P, Mayer JE, Colan SD (2004) Long-term predictors of aortic root dilation and aortic regurgitation after arterial switch operation. Circulation 110:II128-132CrossRef Schwartz ML, Gauvreau K, del Nido P, Mayer JE, Colan SD (2004) Long-term predictors of aortic root dilation and aortic regurgitation after arterial switch operation. Circulation 110:II128-132CrossRef
11.
Zurück zum Zitat Losay J, Touchot A, Serraf A, Litvinova A, Lambert V, Piot JD, Lacour-Gayet F, Capderou A, Planche C (2001) Late outcome after arterial switch operation for transposition of the great arteries. Circulation 104:I121-126CrossRef Losay J, Touchot A, Serraf A, Litvinova A, Lambert V, Piot JD, Lacour-Gayet F, Capderou A, Planche C (2001) Late outcome after arterial switch operation for transposition of the great arteries. Circulation 104:I121-126CrossRef
12.
Zurück zum Zitat Mavroudis C, Stewart RD, Backer CL, Rudra H, Vargo P, Jacobs ML (2011) Reoperative techniques for complications after arterial switch. Ann Thorac Surg 92:1747–1754 (discussion 54–55)CrossRef Mavroudis C, Stewart RD, Backer CL, Rudra H, Vargo P, Jacobs ML (2011) Reoperative techniques for complications after arterial switch. Ann Thorac Surg 92:1747–1754 (discussion 54–55)CrossRef
13.
Zurück zum Zitat Lange R, Cleuziou J, Horer J, Holper K, Vogt M, Tassani-Prell P, Schreiber C (2008) Risk factors for aortic insufficiency and aortic valve replacement after the arterial switch operation. Eur J Cardiothorac Surg 34:711–717CrossRef Lange R, Cleuziou J, Horer J, Holper K, Vogt M, Tassani-Prell P, Schreiber C (2008) Risk factors for aortic insufficiency and aortic valve replacement after the arterial switch operation. Eur J Cardiothorac Surg 34:711–717CrossRef
14.
Zurück zum Zitat Zanjani KS, Niwa K (2013) Aortic dilatation and aortopathy in congenital heart diseases. J Cardiol 61:16–21CrossRef Zanjani KS, Niwa K (2013) Aortic dilatation and aortopathy in congenital heart diseases. J Cardiol 61:16–21CrossRef
15.
Zurück zum Zitat Nakayama Y, Shinkawa T, Matsumura G, Hoki R, Kobayashi K, Niinami H (2019) Late neo-aortic valve regurgitation long after arterial switch operation. Ann Thorac Surg 108:1210–1216CrossRef Nakayama Y, Shinkawa T, Matsumura G, Hoki R, Kobayashi K, Niinami H (2019) Late neo-aortic valve regurgitation long after arterial switch operation. Ann Thorac Surg 108:1210–1216CrossRef
16.
Zurück zum Zitat Kanda Y (2013) Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant 48:452–458CrossRef Kanda Y (2013) Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant 48:452–458CrossRef
17.
Zurück zum Zitat Martins CN, Gontijo Filho B, Lopes RM, Silva F (2018) Mid- and longterm neo-aortic valve regurgitation after Jatene surgery: prevalence and risk factors. Arq Bras Cardiol 111:21–28PubMedPubMedCentral Martins CN, Gontijo Filho B, Lopes RM, Silva F (2018) Mid- and longterm neo-aortic valve regurgitation after Jatene surgery: prevalence and risk factors. Arq Bras Cardiol 111:21–28PubMedPubMedCentral
18.
Zurück zum Zitat Rahimi K, Mohseni H, Kiran A, Tran J, Nazarzadeh M, Rahimian F, Woodward M, Dwyer T, MacMahon S, Otto CM (2018) Elevated blood pressure and risk of aortic valve disease: a cohort analysis of 5.4 million UK adults. Eur Heart J 39:3596–3603CrossRef Rahimi K, Mohseni H, Kiran A, Tran J, Nazarzadeh M, Rahimian F, Woodward M, Dwyer T, MacMahon S, Otto CM (2018) Elevated blood pressure and risk of aortic valve disease: a cohort analysis of 5.4 million UK adults. Eur Heart J 39:3596–3603CrossRef
19.
Zurück zum Zitat Jankowski P, Bilo G, Kawecka-Jaszcz K (2007) The pulsatile component of blood pressure: its role in the pathogenesis of atherosclerosis. Blood Press 16:238–245CrossRef Jankowski P, Bilo G, Kawecka-Jaszcz K (2007) The pulsatile component of blood pressure: its role in the pathogenesis of atherosclerosis. Blood Press 16:238–245CrossRef
20.
Zurück zum Zitat Safar ME, Levy BI, Struijker-Boudier H (2003) Current perspectives on arterial stiffness and pulse pressure in hypertension and cardiovascular diseases. Circulation 107:2864–2869CrossRef Safar ME, Levy BI, Struijker-Boudier H (2003) Current perspectives on arterial stiffness and pulse pressure in hypertension and cardiovascular diseases. Circulation 107:2864–2869CrossRef
21.
Zurück zum Zitat Cavalcante JL, Lima JA, Redheuil A, Al-Mallah MH (2011) Aortic stiffness: current understanding and future directions. J Am Coll Cardiol 57:1511–1522CrossRef Cavalcante JL, Lima JA, Redheuil A, Al-Mallah MH (2011) Aortic stiffness: current understanding and future directions. J Am Coll Cardiol 57:1511–1522CrossRef
22.
Zurück zum Zitat Takeuchi T (1996) Histological analysis of ascending aorta and proximal pulmonary artery in patients with one-stage Jatene procedure. Acta Pediatr Cardiol Jpn 12:506–512 Takeuchi T (1996) Histological analysis of ascending aorta and proximal pulmonary artery in patients with one-stage Jatene procedure. Acta Pediatr Cardiol Jpn 12:506–512
23.
Zurück zum Zitat Sawatari H, Chishaki A, Nishizaka M, Miyazono M, Tokunou T, Magota C, Yamamoto U, Handa SS, Ando SI (2020) Accumulated nocturnal hypoxemia predict arterial endothelial function in patients with sleep-disordered breathing with or without chronic heart failure. Heart Vessels 35(6):800–807CrossRef Sawatari H, Chishaki A, Nishizaka M, Miyazono M, Tokunou T, Magota C, Yamamoto U, Handa SS, Ando SI (2020) Accumulated nocturnal hypoxemia predict arterial endothelial function in patients with sleep-disordered breathing with or without chronic heart failure. Heart Vessels 35(6):800–807CrossRef
24.
Zurück zum Zitat Tan JL, Davlouros PA, McCarthy KP, Gatzoulis MA, Ho SY (2005) Intrinsic histological abnormalities of aortic root and ascending aorta in tetralogy of Fallot: evidence of causative mechanism for aortic dilatation and aortopathy. Circulation 112:961–968CrossRef Tan JL, Davlouros PA, McCarthy KP, Gatzoulis MA, Ho SY (2005) Intrinsic histological abnormalities of aortic root and ascending aorta in tetralogy of Fallot: evidence of causative mechanism for aortic dilatation and aortopathy. Circulation 112:961–968CrossRef
25.
Zurück zum Zitat Niwa K, Perloff JK, Bhuta SM, Laks H, Drinkwater DC, Child JS, Miner PD (2001) Structural abnormalities of great arterial walls in congenital heart disease: light and electron microscopic analyses. Circulation 103:393–400CrossRef Niwa K, Perloff JK, Bhuta SM, Laks H, Drinkwater DC, Child JS, Miner PD (2001) Structural abnormalities of great arterial walls in congenital heart disease: light and electron microscopic analyses. Circulation 103:393–400CrossRef
26.
Zurück zum Zitat Cheung YF, Ou X, Wong SJ (2006) Central and peripheral arterial stiffness in patients after surgical repair of tetralogy of Fallot: implications for aortic root dilatation. Heart 92:1827–1830CrossRef Cheung YF, Ou X, Wong SJ (2006) Central and peripheral arterial stiffness in patients after surgical repair of tetralogy of Fallot: implications for aortic root dilatation. Heart 92:1827–1830CrossRef
27.
Zurück zum Zitat Senzaki H, Iwamoto Y, Ishido H, Matsunaga T, Taketazu M, Kobayashi T, Asano H, Katogi T, Kyo S (2008) Arterial haemodynamics in patients after repair of tetralogy of Fallot: influence on left ventricular after load and aortic dilatation. Heart 94:70–74CrossRef Senzaki H, Iwamoto Y, Ishido H, Matsunaga T, Taketazu M, Kobayashi T, Asano H, Katogi T, Kyo S (2008) Arterial haemodynamics in patients after repair of tetralogy of Fallot: influence on left ventricular after load and aortic dilatation. Heart 94:70–74CrossRef
28.
Zurück zum Zitat Jekell A, Kalani M, Kahan T (2019) The interrelation of endothelial function and microvascular reactivity in different vascular beds, and risk assessment in hypertension: results from the Doxazosin-ramipril study. Heart Vessels 34(3):484–495CrossRef Jekell A, Kalani M, Kahan T (2019) The interrelation of endothelial function and microvascular reactivity in different vascular beds, and risk assessment in hypertension: results from the Doxazosin-ramipril study. Heart Vessels 34(3):484–495CrossRef
29.
Zurück zum Zitat Heeneman S, Sluimer JC, Daemen MJ (2007) Angiotensin-converting enzyme and vascular remodeling. Circ Res 101(5):441–454CrossRef Heeneman S, Sluimer JC, Daemen MJ (2007) Angiotensin-converting enzyme and vascular remodeling. Circ Res 101(5):441–454CrossRef
30.
Zurück zum Zitat Laurent S, Boutouyrie P, Vascular Mechanism C (2014) Dose-dependent arterial destiffening and inward remodeling after olmesartan in hypertensives with metabolic syndrome. Hypertension 64(4):709–716CrossRef Laurent S, Boutouyrie P, Vascular Mechanism C (2014) Dose-dependent arterial destiffening and inward remodeling after olmesartan in hypertensives with metabolic syndrome. Hypertension 64(4):709–716CrossRef
31.
Zurück zum Zitat Jekell A, Kalani M, Kahan T (2017) The effects of alpha 1-adrenoceptor blockade and angiotensin converting enzyme inhibition on central and brachial blood pressure and vascular reactivity: the Doxazosin-ramipril study. Heart Vessels 32(6):674–684CrossRef Jekell A, Kalani M, Kahan T (2017) The effects of alpha 1-adrenoceptor blockade and angiotensin converting enzyme inhibition on central and brachial blood pressure and vascular reactivity: the Doxazosin-ramipril study. Heart Vessels 32(6):674–684CrossRef
32.
Zurück zum Zitat Matt P, Schoenhoff F, Habashi J, Holm T, Van Erp C, Loch D, Carlson OD, Griswold BF, Fu Q, De Backer J, Loeys B, Huso DL, McDonnell NB, Van Eyk JE, Dietz HC, Gen TACC (2009) Circulating transforming growth factor-beta in Marfan syndrome. Circulation 120(6):526–532CrossRef Matt P, Schoenhoff F, Habashi J, Holm T, Van Erp C, Loch D, Carlson OD, Griswold BF, Fu Q, De Backer J, Loeys B, Huso DL, McDonnell NB, Van Eyk JE, Dietz HC, Gen TACC (2009) Circulating transforming growth factor-beta in Marfan syndrome. Circulation 120(6):526–532CrossRef
33.
Zurück zum Zitat Yetman AT, Bornemeier RA, McCrindle BW (2005) Usefulness of enalapril versus propranolol or atenolol for prevention of aortic dilation in patients with the Marfan syndrome. Am J Cardiol 95(9):1125–1127CrossRef Yetman AT, Bornemeier RA, McCrindle BW (2005) Usefulness of enalapril versus propranolol or atenolol for prevention of aortic dilation in patients with the Marfan syndrome. Am J Cardiol 95(9):1125–1127CrossRef
34.
Zurück zum Zitat Cheung YF, Chow PC, So EK, Chan KW (2019) Circulating transforming growth factor-beta and aortic dilation in patients with repaired congenital heart disease. Sci Rep 9(1):162CrossRef Cheung YF, Chow PC, So EK, Chan KW (2019) Circulating transforming growth factor-beta and aortic dilation in patients with repaired congenital heart disease. Sci Rep 9(1):162CrossRef
35.
Zurück zum Zitat Martins D, Khraiche D, Legendre A, Boddaert N, Raisky O, Bonnet D, Raimondi F (2019) Aortic angle is associated with neo-aortic root dilatation and regurgitation following arterial switch operation. Int J Cardiol 280:53–56CrossRef Martins D, Khraiche D, Legendre A, Boddaert N, Raisky O, Bonnet D, Raimondi F (2019) Aortic angle is associated with neo-aortic root dilatation and regurgitation following arterial switch operation. Int J Cardiol 280:53–56CrossRef
Metadaten
Titel
Predictors of neo-aortic valve regurgitation in the long term after arterial switch operation
verfasst von
Takuma Takada
Seiji Asagai
Masaki Sato
Gen Harada
Eriko Shimada
Mikiko Ishido
Tokuko Shinohara
Kei Inai
Nobuhisa Hagiwara
Publikationsdatum
27.11.2020
Verlag
Springer Japan
Erschienen in
Heart and Vessels / Ausgabe 5/2021
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-020-01729-3

Weitere Artikel der Ausgabe 5/2021

Heart and Vessels 5/2021 Zur Ausgabe

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.