Abstract
Background: In complete or dextro-transposition of the great arteries (dTGA), the aorta and the pulmonary artery are transposed. The present study was designed to examine dTGA-associated left atrial (LA) volumetric and functional abnormalities in adult patients late after repair and to compare their results to those of healthy controls. Methods: The present study consisted of 15 dTGA patients (30.3 ± 8.1 years, 9 males), the patients had Mustard (n = 8) or Senning (n = 7) procedure performed. Their results were compared to those of 36 age- and gender-matched healthy subjects (28.7 ± 1.5 years, 24 males). Results: Increased maximum LA volume and reduced LA emptying fractions respecting the cardiac cycle could be demonstrated in our dTGA patients. LA stroke volumes representing all LA functions were significantly reduced. Peak LA circumferential, longitudinal, and area strains and LA circumferential, longitudinal, and area strains measured at atrial contraction were reduced in our dTGA patients. Most LA strains were reduced in patients having Mustard surgery compared to controls and patients undergoing Senning operation. Conclusions: Significant LA volumetric and functional abnormalities could be demonstrated in adult patients with dTGA late after repair. Senning procedure seems to have more beneficial long-term effects on LA volumetric and functional features as compared to the Mustard procedure.
Highlights
Complete or dextro-transposition of the great arteries is a rare cyanotic congenital heart disease (CHD) representing 5–7% of all CHDs. dTGA affects males in 60–70% [1,2]
In dTGA, the aorta arises from a morphological right ventricle (RV), while the pulmonary artery arises from a morphological left ventricle (LV) leading to parallel running systemic and pulmonary circulations
Clinical and two-dimensional echocardiographic data are presented in Table 1. dTGA was associated with atrial septal defect in 2 patients, ventricular septal defect was found in 4 patients, patent ductus arteriosus was present in 5 patients
Summary
Complete or dextro-transposition of the great arteries (dTGA) is a rare cyanotic congenital heart disease (CHD) representing 5–7% of all CHDs. dTGA affects males in 60–70% [1,2]. The present study was designed to examine dTGA-associated LA volumetric and functional abnormalities in adult operated patients and to compare the results with those of healthy controls. It was tested whether Senning or Mustard operation is associated with more beneficial LA volumetric and functional properties. The present study was designed to examine dTGA-associated left atrial (LA) volumetric and functional abnormalities in adult patients late after repair and to compare their results to those of healthy controls. Methods: The present study consisted of 15 dTGA patients (30.3 ± 8.1 years, 9 males), the patients had Mustard (n = 8) or Senning (n = 7) procedure performed Their results were compared to those of 36 age- and gender-matched healthy subjects (28.7 ± 1.5 years, 24 males). Senning procedure seems to have more beneficial long-term effects on LA volumetric and functional features as compared to the Mustard procedure
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