Attenuation of Pulse Pressure Amplification in Patients with Complete Transposition of the Great Arteries After an Arterial Switch Operation in Children
Although the arterial switch operation has become the standard procedure for infants with complete transposition of the great arteries, possible late adverse events after surgery have not been fully elucidated. One such problem may be the postoperative function of the aorta that is radically manipulated. The current study enrolled 12 patients aged 4–9 years who had undergone an arterial switch operation. The ascending and descending aortic pressure waveforms were recorded by a catheter-mounted pressure sensor. The pressure values were compared with those of 28 age-matched controls. The mean patient age was 6.5 ± 1.0 years, and the mean age at the time of surgery was 15.2 ± 8.7 days. The pulse pressure in the ascending aorta was greater in the patients than in the controls (37.7 ± 5.7 vs. 33.5 ± 5.3 mmHg, p = 0.042), while no difference was observed at the descending aorta between the two groups (39.5 ± 5.1 vs. 37.4 ± 5.4 mmHg, respectively, p = 0.27). The pulse pressure amplification, defined as the pulse pressure in the descending aorta minus that in the ascending aorta, was significantly lower in patients who had undergone the arterial switch operation than in control patients (1.8 ± 1.6 vs. 4.0 ± 2.3 mmHg, p = 0.0052). The augmented pulse pressure in the ascending aorta and attenuated pulse pressure amplification observed in children treated with arterial switch surgery for complete transposition of the great arteries may implicate the procedure as a cause of future cardiovascular disease.
KeywordsPulse pressure Complete transposition of the great arteries Arterial switch operation Cardiovascular disease Pulse pressure amplification
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from the parents of all patients.
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