Heart (British Cardiac Society) · 2026
Aortic coarctation and long-term morbidity after arterial switch operation: a multicentre international cohort study.
СтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ruperti-Repilado Francisco Javier, Ladrón Raquel, Lopez-Ayala Pedro, Gabra Beshoy, González-Fernández Victor, Engele Leo J, Manso Begoña, Bouma Berto J, Gabriel Harald, Schwitz Fabienne, Possner Mathias, Schwerzmann Markus, Rueda Joaquín, Buendía-Fuentes Francisco, Bouchardy Judith, Ladouceur Magalie, Dos-Subirà Laura, Greutmann Matthias, Tobler Daniel, Gallego Pastora
Аннотация
BACKGROUND: In patients with dextro-transposition of the great arteries, cardiovascular interventions and complications are common after the arterial switch operation (ASO). While complex anatomy-typically defined by ventricular septal defects (VSDs)-is often linked to these outcomes, the independent role of aortic coarctation (CoA) remains unclear.
METHODS: We analysed 502 adults from the EPOCH (European collaboration for Prospective Outcome research in Congenital Heart disease)-ASO multicentre registry (median age 25.5 years). The primary outcome was time to first right ventricular outflow tract (RVOT)-related intervention. Secondary outcomes included left ventricular outflow tract (LVOT)-related interventions and cardiovascular complications. Associations were assessed using adjusted Cox regression and Andersen-Gill models.
RESULTS: CoA emerged as the strongest independent predictor of RVOT interventions (HR 2.62), LVOT interventions (HR 10.75) and cardiovascular complications (HR 2.16). In contrast, VSD (complex anatomy) showed weaker or no associations. CoA also predicted higher recurrence rates of both RVOT and LVOT interventions.
CONCLUSIONS: Among adults post-ASO, CoA-not VSD-is the dominant anatomical driver of long-term morbidity. These patients require targeted surgical attention and structured, lifelong follow-up to mitigate future complications.
TRIAL REGISTRATION NUMBER: NCT04335448.
METHODS: We analysed 502 adults from the EPOCH (European collaboration for Prospective Outcome research in Congenital Heart disease)-ASO multicentre registry (median age 25.5 years). The primary outcome was time to first right ventricular outflow tract (RVOT)-related intervention. Secondary outcomes included left ventricular outflow tract (LVOT)-related interventions and cardiovascular complications. Associations were assessed using adjusted Cox regression and Andersen-Gill models.
RESULTS: CoA emerged as the strongest independent predictor of RVOT interventions (HR 2.62), LVOT interventions (HR 10.75) and cardiovascular complications (HR 2.16). In contrast, VSD (complex anatomy) showed weaker or no associations. CoA also predicted higher recurrence rates of both RVOT and LVOT interventions.
CONCLUSIONS: Among adults post-ASO, CoA-not VSD-is the dominant anatomical driver of long-term morbidity. These patients require targeted surgical attention and structured, lifelong follow-up to mitigate future complications.
TRIAL REGISTRATION NUMBER: NCT04335448.