Congenital heart disease

Growth of the Neo-Aortic Root and Prognosis of Transposition of the Great Arteries

J Am Coll CardiolPublished Retrospective cohort study

Study context

Population
Patients who underwent the arterial switch operation (ASO) for dextro-transposition of the great arteries (d-TGA), July 1, 1981 to September 30, 2022
Participants
1,359 patients
Exposure
Neo-aortic root growth by intrinsic morphology after ASO
  • Dextro-transposition of the great arteries with intact ventricular septum (d-TGA-IVS)n = 593reference
  • Dextro-transposition of the great arteries with ventricular septal defect (d-TGA-VSD)n = 666
  • DORV-TGAn = 100
Outcome
Growth of the neo-aortic root (echocardiographic diameters and z scores at annulus, sinus of Valsalva and sinotubular junction)
Methodological detailssingle-centre
  • Single-centre

Main finding

As reported in the abstract

Neo-aortic root dilatation, DORV-TGA vs d-TGA-IVS · 30 years
  • DORV-TGA vs d-TGA-IVS: P < 0.001
  • DORV-TGA vs d-TGA-IVS: P = 0.039
  • DORV-TGA vs d-TGA-IVS: P = 0.041
  • Median follow-up 8.6 years (range: 0.1-39.3 years)
  • Median 5 echocardiograms (Q1-Q3: 3-10) per patient

Observational data: associations, not effects.

Further findings

Composite of moderate-severe aortic regurgitation (AR) and neo-aortic valve or root intervention at late follow-up (multivariable)

Associated with intrinsic anatomy, older age at ASO, at least mild AR at baseline and high-risk root dilatation
all P < 0.05
  • Multivariable Cox proportional hazards models

Original publication

Growth of the Neo-Aortic Root and Prognosis of Transposition of the Great Arteries. J Am Coll Cardiol. Published 6 November 2023. doi:10.1016/j.jacc.2023.10.023

Summarised from the published abstract; every number is checked against it

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