Congenital heart diseaseCohort study
Biventricular Pressure-Volume Area Ratio for the Assessment of Left Ventricular Preparedness for Double Switch Operation
- Retrospective cohort
- conductance catheter validation
- univariate Cox proportional hazards
Authors' conclusion
Estimation of subpulmonary LV-PVA using simple imaging and catheterization data was reliable compared to gold standards. LV:RV ePVA ratio ≥0.67 may serve as a good discriminator for LV preparedness for DSO for congenitally corrected transposition of the great arteries/intact ventricular septum.
Study context
- Population
- Patients with congenitally corrected transposition of the great arteries/intact ventricular septum undergoing double switch operation (DSO)retrospective cohort, validation of ePVA against measured pressure-volume area (PVA) in n = 20 · validation (measured PVA) 20 · retrospective cohort 42
- Participants
- 42 patients
- Exposure
- Left ventricular (LV):Right ventricular (RV) ePVA ratio and clinical variables vs composite outcome (≥moderate LV dysfunction, transplant, or death); ePVA vs measured PVA
Main finding
As reported in the abstract
Agreement of ePVA with measured PVA
- High agreement and low bias with measured PVA
- n = 20
Observational data: associations, not effects.
Further findings
Associations with composite outcome
| Comparison | HR (95% CI) | |
|---|---|---|
| Low LV:RV ePVA ratio · univariate Cox proportional hazards | 3.9 (1.5–10.0) | |
| Low pressure ratio · univariate Cox proportional hazards | 2.4 (1.3–4.2) | |
| 0.10.31310Hazard ratio (log scale) |
Composite outcome (≥moderate LV dysfunction, transplant, or death) · median follow-up 1.65 [0.12, 4.58] years
- Patients with composite outcome
- 6/42 patients (14%)
- Median age at DSO
- 2.9 years
Associations with composite outcome
- LV mass indices not significantly associated
Adverse outcome among patients with borderline pressure ratios (subgroup)
- Of 8 patients with borderline pressure ratios, those with ePVA ratio <0.67 who had adverse outcome
- 5
- Of 8 patients with borderline pressure ratios, those with ePVA ratio ≥0.67, none with adverse outcome
- 3
Original publication
Biventricular Pressure-Volume Area Ratio for the Assessment of Left Ventricular Preparedness for Double Switch Operation. JACC Adv. Published 24 February 2026. doi:10.1016/j.jacadv.2026.102616
Summarised from the published abstract; every number is checked against it