Open Access
ARTICLE
Comprehensive Long-Term Follow up of Adults with Arterial Switch Operation– European Collaboration for Prospective Outcome Research in Congenital Heart Disease (EPOCH-ASO)–Study Design and Protocols
Francisco Javier Ruperti-Repilado1,#,*, Magalie Ladouceur2,#, Pastora Gallego3, Laura Dos4, Joaquin Rueda Soriano5, Berto Bouma6, Harald Gabriel7, Markus Schwerzmann1, Judith Bouchardy8,9, Daniel Tobler10,#, Matthias Greutmann11,#
1 Center for Congenital Heart Disease, Cardiology, University Hospital Inselspital, University of Bern, Bern, Switzerland
2 Université de Paris, Hôpital Européen Georges Pompidou, AP-HP, Adult Congenital Heart Disease Unit, Centre de référence des Malformations Cardiaques Congénitales Complexes, M3C. Inserm U970, Paris Centre de Recherche Cardiovasculaire, Paris, France
3 Adult Congenital Heart Disease Unit, Department of Cardiology, Hospital Universitario Virgen del Rocio, Instituto de BioMedicina de Sevilla and CIBERCV, Sevilla, Spain
4 Unitat de Cardiopaties Congènites de l’Adolescent i l’Adult Vall d’Hebron-Sant Pau, Hospital Universitari Vall d’Hebron, Barcelona, Spain
5 Adult Congenital Heart Disease Unit, Department of Cardiology, Hospital Universitari i Politècnic La Fe and CIBERCV, València, Spain
6 Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands
7 Adult Congenital Heart Disease Program, Department of Cardiology, Medical University of Vienna, Vienna, Austria
8 Department of Cardiology and Cardiac Surgery, University Hospital Lausanne, Lausanne, Switzerland
9 Division of Cardiology, University Hospital Geneva, Geneva, Switzerland
10 Division of Cardiology, University Hospital of Basel, University of Basel, Basel, Switzerland
11 University Heart Center, Department of Cardiology, University of Zurich, Zurich, Switzerland
# These authors contributed equally to the study design, data interpretation, and manuscript preparation
* Corresponding Author: Francisco Javier Ruperti-Repilado. Email:
Congenital Heart Disease 2020, 15(5), 309-338. https://doi.org/10.32604/CHD.2020.012599
Received 06 July 2020; Accepted 24 August 2020; Issue published 23 September 2020
Abstract
Background: Long-term outcomes in adults with prior arterial switch
operation (ASO) have not yet been well defined. The aim of this study is to elucidate incidence and predictors of adverse cardiac outcomes in a prospectively
followed cohort of adults after their ASO.
Methods: The comprehensive longterm follow up of adults with ASO is a project within the European collaboration
for prospective outcome research in congenital heart disease (EPOCH). It is
designed as a prospective, international multicenter cohort study. Consecutive
patients (age ≥ 16 years) with prior ASO will be included at 11 European tertiary
care centers. Participants will be followed according to a standardized protocol
following international recommendations, including standardized protocols for
imaging and for exercise testing.
Results: Main outcome measures are all-cause
and cardiac-related mortality, rate of cardiac re-intervention, neo-aortic dissection,
myocardial infarction, stroke, infective endocarditis, sustained atrial and ventricular arrhythmias, new-onset or worsening pulmonary hypertension or heart failure.
Secondary endpoints are frequency and progression of right ventricular outflow
stenosis, neo-aortic root dilatation, neo-aortic valve regurgitation and ventricular dysfunction. The impact of demographic, anatomic (e.g., coronary artery anatomy) and functional variables on the above-mentioned outcomes, as well as quality
of life and incidence of pregnancy related complications will also be assessed.
Conclusion: The prospective, international, multicenter EPOCH-ASO study will
provide a better understanding of adverse outcomes and their predictors in adults
after ASO. The results of the EPOCH-ASO study may help to optimize future
care of this novel patient cohort in adult cardiology.
Keywords
Cite This Article
Ruperti-Repilado, F. J., Ladouceur, M., Gallego, P., Dos, L., Soriano, J. R. et al. (2020). Comprehensive Long-Term Follow up of Adults with Arterial Switch Operation– European Collaboration for Prospective Outcome Research in Congenital Heart Disease (EPOCH-ASO)–Study Design and Protocols.
Congenital Heart Disease, 15(5), 309–338.