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Long-term Management of the Arterial Switch Patient

  • Congenital Heart Disease (RA Krasuski, Section Editor)
  • Published:
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Abstract

Purpose of Review

This review paper describes the management of patients with dextro-transposition of the great arteries (D-TGA) with a focus on the complications seen and the appropriate care required to identify and prevent adverse events.

Recent Findings

D-TGA is a form of cyanotic congenital heart disease (CHD) representing ~ 3% of all CHD and almost 20% of all cyanotic CHD. Since the late 1980s, standard of care is to repair these patients with an arterial switch operation (ASO) as opposed to a Mustard/Senning operation. The long-term survival and complication rates are superior in the ASO.

Summary

Long-term follow-up is recommended for all D-TGA patients and includes management with adult congenital heart disease specialists and the use of echocardiography and advanced imaging with CT or MRI. The most common complications seen are pulmonary stenosis, coronary artery stenosis, and neo-aortic regurgitation. Careful evaluation of new symptoms or declining function is essential in preventing and treating these long-term sequelae.

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  1. Jared Kirzner and Altaf Pirmohamed co-first authors based on equal contribution on writing this review paper.

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  1. Cornell Center for Adult Congenital Heart Disease, Departments of Medicine and Pediatrics, Division of Cardiology, New York Presbyterian Hospital, Weill Cornell Medicine, 520 East 70th Street, Starr 425, New York, NY, 10021, USA

    Jared Kirzner, Altaf Pirmohamed, Jonathan Ginns & Harsimran S. Singh

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Kirzner, J., Pirmohamed, A., Ginns, J. et al. Long-term Management of the Arterial Switch Patient. Curr Cardiol Rep 20, 68 (2018). https://doi.org/10.1007/s11886-018-1012-9

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