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Angiotensin-converting enzyme inhibitors in adults after the Mustard procedure

S J Hechter1, P M Fredriksen, P Liu

  • 1University of Toronto Congenital Cardiac Centre for Adults and Department of Medical Imaging, The Toronto General Hospital, Ontario, Canada.

Insights

Angiotensin-converting enzyme inhibitors did not significantly impact cardiopulmonary exercise function in patients after a Mustard operation for transposition of the great arteries. However, some individuals experienced improved aerobic capacity and reduced blood pressure.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Cardiovascular Surgery

Background:

  • Transposition of the great arteries (TGA) is a congenital heart defect requiring surgical correction.
  • The Mustard operation is a palliative surgical procedure for TGA.
  • Long-term effects of TGA repair on cardiopulmonary function require further investigation.

Purpose of the Study:

  • To evaluate the effect of angiotensin-converting enzyme inhibitors on cardiopulmonary exercise function in patients post-Mustard operation.
  • To assess the impact of these medications on aerobic capacity and blood pressure in this population.

Main Methods:

  • A study involving 14 patients who previously underwent the Mustard operation for TGA.
  • Assessment of cardiopulmonary exercise function before and during treatment with angiotensin-converting enzyme inhibitors.
  • Measurement of aerobic capacity and maximum systolic blood pressure.

Main Results:

  • Angiotensin-converting enzyme inhibitors showed no significant effect on overall cardiopulmonary exercise function.
  • A subset of patients demonstrated improvements in aerobic capacity.
  • A decrease in maximum systolic blood pressure was observed in some patients.

Conclusions:

  • Angiotensin-converting enzyme inhibitors may not be beneficial for improving general cardiopulmonary exercise function in patients after a Mustard operation for TGA.
  • Individualized responses regarding aerobic capacity and blood pressure warrant further research.

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