Left and right ventricular performance after arterial switch operation.

Area of Science:

• Cardiology
• Pediatric Cardiac Surgery
• Echocardiography

Background:

• Arterial switch operation (ASO) is a common surgical procedure for transposition of the great arteries.
• Long-term exercise capacity deficits suggest potential subclinical hemodynamic issues post-ASO.
• Ventricular performance impairment may contribute to reduced exercise capacity after ASO.

Purpose of the Study:

• To investigate the temporal changes in biventricular systolic and diastolic performance within the first year following ASO.
• To compare ventricular function in ASO patients with age-matched controls.

Main Methods:

• Prospective study of 26 patients undergoing ASO and 20 controls.
• Assessment of left and right ventricular function using tissue Doppler imaging and speckle tracking strain imaging.
• Evaluations performed preoperatively, early postoperatively, at discharge, and at 9-month follow-up.

Main Results:

• Biventricular function initially decreased post-ASO but recovered by medium-term follow-up.
• Left ventricular systolic and diastolic performance normalized compared to controls at 9 months.
• Right ventricular systolic and diastolic function remained significantly impaired at 9 months post-ASO.

Conclusions:

• Left ventricular function recovers to normal levels within one year after ASO.
• Persistent right ventricular dysfunction post-ASO underscores the importance of regular echocardiographic monitoring.
• Early identification and management of right ventricular impairment are crucial for long-term outcomes.