Open Access
ARTICLE
Late-Onset Pulmonary Hypertension After the Atrial Switch Procedure for Transposition of the Great Arteries
Masataka Ogiso1,2, Kei Inai1,*, Morio Shoda2, Nobuhisa Hagiwara2, Hisashi Sugiyama1
1 Department of Pediatric Cardiology and Adult Congenital Cardiology, Tokyo Women’s Medical University, Tokyo, Japan
2 Department of Cardiology, Tokyo Women’s Medical University, Tokyo, Japan
* Corresponding Author: Kei Inai. Email:
Congenital Heart Disease 2020, 15(6), 483-493. https://doi.org/10.32604/CHD.2020.013058
Received 24 July 2020; Accepted 21 September 2020; Issue published 02 November 2020
Abstract
Background: Pulmonary hypertension (PH) is one of the complications that can occur after the atrial switch procedure for transposition of the great
arteries (TGA). This study aimed to assess the characteristics and prognosis
of late-onset PH after the atrial switch procedure using catheterization data.
Methods and Results: We retrospectively identified 40 patients with TGA after
the atrial switch procedure that underwent catheterization between April 2007 and
March 2020. Eligible patients were divided into two groups based on PH presence
(PH group, n = 13 [33%]; non-PH group, n = 27 [67%]). Adverse events were
defined as cardiac death and heart failure. Of the included patients, 63% were
male, the mean (± standard deviation [SD]) age was 34.3 ± 8.8 years, and 43%
had Mustard operations. During the follow-up period (mean ± SD, 4.3 ±
3.5 years), adverse events were significantly more common in the PH group than
in the non-PH group (hazard ratio 4.5, 95% confidence interval 0.99-23.0, logrank
p = 0.032). There were five patients who underwent catheterization twice
during the follow-up period. Two of the five patients who had post capillary
PH had improved PH and New York Heart Association (NYHA) class due to appropriate early treatment initiation for heart failure, which included diuretics, angiotensinconverting-enzyme inhibitor/angiotensin II receptor blocker, and β-blockers.
Conclusions: PH is very prevalent in adults with TGA who underwent the atrial
switch procedure and is associated with an adverse prognosis. Early appropriate
therapy might improve PH and NYHA class after the atrial switch procedure.
Keywords
Cite This Article
Ogiso, M., Inai, K., Shoda, M., Hagiwara, N., Sugiyama, H. (2020). Late-Onset Pulmonary Hypertension After the Atrial Switch Procedure for Transposition of the Great Arteries.
Congenital Heart Disease, 15(6), 483–493. https://doi.org/10.32604/CHD.2020.013058