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
Abstract Views: 1074
PDF: 343
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
Vida VL, Zanotto L, Zanotto L, et al. Arterial switch operation for transposition of the greatest arteries: a single-centre 32-year experience. J Card Surg 2019;34:1154-61.
Jonas RA. The arterial switch operation in 2019: how to do it and how to teach it. World J Pediatr Congenit Heart Surg 2019;1:90-7.
Lalezari S, Bruggemans EF, Blom NA, Hazekamp MG. Thirty-year experience with the arterial switch operation. Ann Thorac Surg 2011;92973-9.
Ou P, Celermajer DS, Raisky O, et al. Angular (gothic) aortic arch leads to enhanced systolic wave reflection, central aortic stiffness, and increased left ventricular mass late after aortic coarctation repair: evaluation with magnetic resonance flow mapping. J Thorac Cardiovasc Surg 2008;135:62-8.
Mariucci E, Spinardi L, Stagni S, et al. Aortic arch geometry predicts outcome in patients with Loeys-Dietz syndrome independent of the causative gene. Am J Med Genet A 2020;182:1673-80.
Voges I, Jerosch-Herold M, Hedderich J, et al. Implications of early aortic stiffening in patients with transposition of the great arteries after arterial switch operation. Circ Cardiovasc Imaging 2013;6:245-53.
Khairy P, Clair M, Fernandes SM, et al. Cardiovascular outcomes after the arterial switch operation for D-transposition of the great arteries. Circulation 2013;127:331-9.
Király L, Hartyánszky I, Prodán Z. Right ventricle failure and outcome of simple and complex arterial switch operations in neonates. Croat Med J 2002;43:660-4.
Kirzner J, Pirmohamed A, Ginns J, Singh HS. Long-term management of the arterial switch patient. Curr Cardiol Rep 2018;20:68.
Keshavarz-Motamed Z, Garcia J, Pibarot P, et al. Modeling the impact of concomitant aortic stenosis and coarctation of the aorta on left ventricular workload. J Biomech 2011;44:2817-25.
Corno AF, von Segesser LK. Transposition of great arteries and single coronary artery: a new surgical technique for the arterial switch operation. Swiss Med Wkly 2001;131:47-9.
Di Salvo G, Al Bulbul Z, Issa Z, et al. Left ventricular mechanics after arterial switch operation: a speckle-tracking echocardiography study. J Cardiovasc Med (Hagerstown) 2016;17:217-24.
Jonas RA. Complete transposition of the great arteries. In: Jonas RA, Elliott MJ, eds. Cardiac surgery of the neonate and infant. Cham: Springer; 2010. pp 249-83.
Xie M, Zhang W, Cheng TO, et al. Left ventricular torsion abnormalities in patients after the arterial switch operation for transposition of the great arteries with intact ventricular septum. Int J Cardiol 2013;168:4631-7.
Cecelja M, Chowienczyk P. Role of arterial stiffness in cardiovascular disease. JRSM Cardiovasc Dis 2012;1:cvd.2012.012016.
Wang C, Li VW, So EK, Cheung YF. Left ventricular stiffness in adolescents and young adults after arterial switch operation for complete transposition of the great arteries. Pediatr Cardiol 2020;41:747-54.
Mahieu D, Kips J, Rietzschel ER, et al. Noninvasive assessment of central and peripheral arterial pressure (waveforms): implications of calibration methods. J Hypertens 2010;28:300-5.
Ioannou CV, Morel DR, Katsamouris AN, et al. Left ventricular hypertrophy induced by reduced aortic compliance. J Vasc Res 2009;46:417-25.
Nyns EC, Dragulescu A, Yoo SJ, Grosse-Wortmann L. Evaluation of knowledge-based reconstruction for magnetic resonance volumetry of the right ventricle after arterial switch operation for dextro-transposition of the great arteries. Int J Cardiovasc Imaging 2016;32:1415-23.
Herberg U, Smit F, Winkler C, et al. Real-time 3D-echocardiography of the right ventricle-paediatric reference values for right ventricular volumes using knowledge-based reconstruction: a multicentre study. Quant Imaging Med Surg 2021;11:2905-17.
Seo DM, Park J, Goo HW, et al. Surgical modification for preventing a gothic arch after aortic arch repair without the use of foreign material. Interact Cardiovasc Thorac Surg 2015;20:504-9.
Baumgartner H, De Backer J, Babu-Narayan SV, et al. 2020 ESC guidelines for the management of adult congenital heart disease. Eur Heart J 2021;42:563-645.
Warmerdam EG, Krings GJ, Meijs TA, et al. Safety and efficacy of stenting for aortic arch hypoplasia in patients with coarctation of the aorta. Neth Heart J 2020;28:145-52.
Crepaz R, Secchieri S, Svaluto G, et al. Echocardiographic evaluation of systolic and diastolic left ventricular function following arterial switch operation in the neonatal period for transposition of the great arteries. Midterm results. G Ital Cardiol 1997;27:224-30.
Walter CC, Escobar-Diaz MC, Cesar S, et al. Functional and morphometric changes in children after neonatal arterial switch operation for transposition of the great arteries. Ann Pediatr Cardiol 2022;15:447-52.
Di Salvo G, Bulbul Z, Pergola V, et al. Gothic aortic arch and cardiac mechanics in young patients after arterial switch operation for d-transposition of the great arteries. Int J Cardiol 2017;241:163-7.
Sirico D, Basso A, Sabatino J, et al. Evolution of echocardiographic and cardiac magnetic resonance imaging abnormalities during follow-up in patients with multisystem inflammatory syndrome in children. Eur Heart J Cardiovasc Imaging 2022;23:1066-74.
Avesani M, Borrelli N, Krupickova S, et al. Echocardiography and cardiac magnetic resonance in children with repaired tetralogy of Fallot: new insights in cardiac mechanics and exercise capacity. Int J Cardiol 2020;321:144-9.
Amedro P, Vincenti M, Abassi H, et al. Use of speckle tracking echocardiography to detect late anthracycline-induced cardiotoxicity in childhood cancer: a prospective controlled cross-sectional study. Int J Cardiol 2022;354:75-83.
Salvo GD, Pergola V, Fadel B, et al. Strain echocardiography and myocardial mechanics: from basics to clinical applications. J Cardiovasc Echogr 2015;25:1-8.
Rentzsch A, Abd El Rahman MY, Hui W, et al. Assessment of myocardial function of the systemic right ventricle in patients with D-transposition of the great arteries after atrial switch operation by tissue Doppler echocardiography. Z Kardiol 2005;94:524-31.
Gnanappa GK, Celermajer DS, Zhu D, et al. Severe right ventricular dilatation after repair of Tetralogy of Fallot is associated with increased left ventricular preload and stroke volume. Eur Heart J Cardiovasc Imaging 2019;20:1020-6.
Pagourelias ED, Papadopoulos CE. Evaluation of myocardial function in pediatric patients with the transposition of great arteries after arterial switch operation. Anatol J Cardiol 2016;16:62.
Li VW, Yu CK, So EK, et al. Ventricular myocardial deformation imaging of patients with repaired tetralogy of Fallot. J Am Soc Echocardiogr 2020;33:788-801.
Voges I, Scheewe J, Attmann T, et al. Abnormal aortic arch shape and vortical flow patterns are associated with descending aortic dilatation in patients with hypoplastic left heart syndrome. Int J Cardiol 2021;323:65-7.
Pieper T, Latus H, Schranz D, et al. Aortic elasticity after aortic coarctation relief: comparison of surgical and interventional therapy by cardiovascular magnetic resonance imaging. BMC Cardiovasc Disord 2019;19:286.
Taylor AM, Thorne SA, Rubens MB, et al. Coronary artery imaging in grown up congenital heart disease: complementary role of magnetic resonance and x-ray coronary angiography. Circulation 2000;101:1670-8.
Dorfman AL, Geva T. Magnetic resonance imaging evaluation of congenital heart disease: conotruncal anomalies. J Cardiovasc Magn Reson 2006;8:645-59.
Lurz P, Nordmeyer J, Giardini A, et al. Early versus late functional outcome after successful percutaneous pulmonary valve implantation: are the acute effects of altered right ventricular loading all we can expect?. J Am Coll Cardiol 2011;57:724-31.
Malahfji M, Chamsi-Pasha MA. Advanced cardiac imaging for complex adult congenital heart diseases. Methodist Debakey Cardiovasc J 2019;15:99-104.
Boussel L, Rayz V, Martin A, et al. Phase-contrast magnetic resonance imaging measurements in intracranial aneurysms in vivo of flow patterns, velocity fields, and wall shear stress: comparison with computational fluid dynamics. Magn Reson Med 2009;61:409-17.
Azarine A, Garçon P, Stansal A, et al. Four-dimensional flow MRI: principles and cardiovascular applications. Radiographics 2019;39:632-48.
Adriaans BP, Wildberger JE, Westenberg JJM, et al. Predictive imaging for thoracic aortic dissection and rupture: moving beyond diameters. Eur Radiol 2019;29:6396-404.
Babu-Narayan SV, Giannakoulas G, Valente AM, et al. Imaging of congenital heart disease in adults. Eur Heart J 2016;37:1182-95.
Warnes CA, Williams RG, Bashore TM, et al. ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association task force on practice guidelines (writing committee to develop guidelines on the management of adults with congenital heart disease). Circulation 2008;118:e714-833.
Woudstra OI, Kuijpers JM, Jongbloed MRM, et al. Medication in adults after atrial switch for transposition of the great arteries: clinical practice and recommendations. Eur Heart J Cardiovasc Pharmacother 2022;8:77-84.
Dragulescu A, Mertens L, Friedberg MK. Interpretation of left ventricular diastolic dysfunction in children with cardiomyopathy by echocardiography: problems and limitations. Circ Cardiovasc Imaging 2013;6:254-61.
van Wijk SW, Driessen MM, Meijboom FJ, et al. Left ventricular function and exercise capacity after arterial switch operation for transposition of the great arteries: a systematic review and meta-analysis. Cardiol Young 2018;28:895-902.
Bruse JL, Khushnood A, McLeod K, et al. How successful is successful? Aortic arch shape after successful aortic coarctation repair correlates with left ventricular function. J Thorac Cardiovasc Surg 2017;153:418-27.
Raimondi F, Vida V, Godard C, et al. Fast-track virtual reality for cardiac imaging in congenital heart disease. J Card Surg 2021;36:2598-602.
Bertelli F, Raimondi F, Godard C, et al. Fast-track virtual reality software to facilitate 3-dimensional reconstruction in congenital heart disease. Interdiscip Cardiovasc Thorac Surg 2023;36:ivad087.
Avesani M, Degrelle B, Di Salvo G, et al. Vector flow mapping: a review from theory to practice. Echocardiography 2021;38:1405-13.
Minotti C, Scioni M, Castaldi B, et al. Effectiveness of repair of aortic coarctation in neonates: a long-term experience. Pediatr Cardiol 2022;43:17-26.
Pergola V, Di Salvo G, Fadel B, et al. The long term results of the Ross procedure: the importance of candidate selection. Int J Cardiol 2020;320:35-41.

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.
Copyright (c) 2023 The Author(s) Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.


Similar Articles

<< < 2 3 4 5 6 7 8 9 10 11 > >> 

You may also start an advanced similarity search for this article.