https://doi.org/10.4081/monaldi.2023.2712

Unveiling the gothic aortic arch and cardiac mechanics: insights from young patients after arterial switch operation for d-transposition of the great arteries

Vol. 94 No. 1 (2024)
Submitted: July 14, 2023
Accepted: September 14, 2023
Published: September 28, 2023
D-transposition of the great arteries, arterial switch operation, cardiac mechanics, gothic aortic arch, echocardiography, therapeutic interventions
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Authors

Valeria Pergola
https://orcid.org/0000-0002-3317-7342
Cardiology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Italy.
Martina Avesani
martina.avesani@aopd.veneto.it
https://orcid.org/0000-0003-4970-4562
Pediatric Cardiology Unit, Department of Woman’s and Child’s Health, University Hospital of Padua, University of Padua, Italy.
Elena Reffo
Pediatric Cardiology Unit, Department of Woman’s and Child’s Health, University Hospital of Padua, University of Padua, Italy.
Stefano da Pozzo
https://orcid.org/0009-0004-8632-7318
Radiology Unit, University Hospital of Padua, Italy.
Annachiara Cavaliere
https://orcid.org/0000-0002-5636-3316
Radiology Unit, University Hospital of Padua, Italy.
Massimo Padalino
https://orcid.org/0000-0002-0343-8118
Pediatric and Congenital Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Italy.
Vladimiro Vida
Pediatric and Congenital Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Italy.
Raffaella Motta
Radiology Unit, Department of Cardiac, Thoracic and Vascular Sciences, and Public Health, University of Padua, Italy.
Giovanni Di Salvo
https://orcid.org/0000-0002-0305-0113
Pediatric Cardiology Unit, Department of Woman’s and Child’s Health, University Hospital of Padua, University of Padua, Italy.

The arterial switch operation (ASO) has become the standard surgical treatment for patients with d-transposition of the great arteries. While ASO has significantly improved survival rates, a subset of patients develop a unique anatomical anomaly known as the gothic aortic arch (GAA). Understanding cardiac mechanics in this population is crucial, as altered mechanics can have profound consequences for cardiac function and exercise capacity. The GAA has been associated with changes in ventricular function, hemodynamics, and exercise capacity. Studies have shown a correlation between the GAA and decreased ascending aorta distensibility, loss of systolic wave amplitude across the aortic arch, and adverse cardiovascular outcomes. Various imaging techniques, including echocardiography, cardiac magnetic resonance imaging, and cardiac computed tomography, play a crucial role in assessing cardiac mechanics and evaluating the GAA anomaly. Despite significant advancements, gaps in knowledge regarding the prognostic implications and underlying mechanisms of the GAA anomaly remain. This review aims to explore the implications of the GAA anomaly on cardiac mechanics and its impact on clinical outcomes in young patients after ASO. Advancements in imaging techniques, such as computational modeling, offer promising avenues to enhance our understanding of cardiac mechanics and improve clinical management.

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How to Cite

Pergola, Valeria, Martina Avesani, Elena Reffo, Stefano da Pozzo, Annachiara Cavaliere, Massimo Padalino, Vladimiro Vida, Raffaella Motta, and Giovanni Di Salvo. 2023. “Unveiling the Gothic Aortic Arch and Cardiac Mechanics: Insights from Young Patients After Arterial Switch Operation for D-Transposition of the Great Arteries”. Monaldi Archives for Chest Disease 94 (1). https://doi.org/10.4081/monaldi.2023.2712.
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