Coronary artery pattern and age impact exercise performance late after the arterial switch operation

Area of Science:

• Cardiology
• Pediatric Cardiac Surgery
• Exercise Physiology

Background:

• The arterial switch operation (ASO) is a common surgical procedure for d-transposition of the great arteries.
• The long-term impact of coronary artery patterns on exercise capacity post-ASO requires further investigation.

Purpose of the Study:

• To assess the relationship between coronary artery patterns and exercise performance in patients long after undergoing the arterial switch operation.
• To identify factors influencing exercise capacity, including maximum heart rate and peak oxygen consumption.

Main Methods:

• Retrospective analysis of 53 patients who underwent exercise stress testing post-ASO.
• Univariate and multivariate analyses to determine risk factors for reduced exercise performance.
• Comparison of exercise parameters between patients with usual and variant coronary artery patterns.

Main Results:

• Patients with variant coronary artery patterns exhibited a significantly lower maximum heart rate compared to those with usual patterns (P=.04).
• Variant coronary artery patterns and ventricular septal defect were predictors of lower maximum heart rate.
• Longer follow-up duration was the strongest predictor of diminished aerobic capacity (percent predicted peak oxygen consumption).

Conclusions:

• Variant coronary artery patterns are linked to chronotropic impairment following the arterial switch operation.
• Reduced aerobic capacity in the long term after ASO is significantly associated with longer follow-up times.