Risk factors of aortic and pulmonary regurgitation after arterial Switch operation

Abstract

Objective To evaluate the risk factors of aortic and pulmonary regurgitation after arterial switch operation (ASO), and to assess the midterm follow-up results after ASO. MethodsFrom December 1999 to December 2007, 288 patients recovered after ASO in our center. Two hundred and twenty eight patients were followed up. The Mean follow-up time was 20.4±18.6 months. The pre-and postoperative aortic and pulmonary valve function were analyzed by echocardiography.Results According to the patterns of cardiac malformation, the patients were divided into 4 groups: the Stage-Switch group, the Taussig-Bing group, the Transposition of the Great Arteries with ventricular septal defect (TGA/VSD) group, and the Great Arteries with Intact Ventricular Septum (TGA/IVS) group. After ASO, the morbility of aortic regurgitation (AR) was significantly different between the 4 groups (P=0.010). There is no difference in the morbility of pulmonary regurgitation (PR) between the 4 groups (P＞0.05). Multivariate analysis suggested the risk factors assosiated with AR development during follow-up were the operation age (＞60 days), AO/PA (＞1.10), and AR at discharge. Univariate analysis revealed the PR at discharge was related to the development of PR during follow-up. Conclusions The morbility of AR increases with the length of follow-up. Mild regurgitation after ASO can alleviate or even disappear during the follow-up. The patient underwent ASO should be followed-up perodically in order to evaluate the valve function and healing of aortic and pulmonary anastomosis. Key words: Aortic valve insufficiency; Pulmonary valve insufficiency