Two decades after the arterial switch operation: stable right ventricular function but reduced exercise capacity.

Background: Right ventricular (RV) function and exercise capacity predict prognosis in transposition of the great arteries (TGA) after arterial switch operation (ASO). We aim to longitudinally evaluate RV dimensions, global function and exercise capacity after ASO, comparing patients with and without RV pressure overload.

Methods: This retrospective study included TGA patients post-ASO with two cardiovascular magnetic resonance (CMRs) examinations at the University Medical Center Utrecht between 2004 and March 2024.

Does stroke volume limit exercise capacity in TGA patients after the arterial switch operation?

Background: Patients with transposition of the great arteries (TGA) experience reduced exercise capacity after the arterial switch operation (ASO), possibly due to limited stroke volume. This study evaluates the role of stroke volume in reduced exercise capacity in these patients.

Methods: A retrospective analysis was conducted on TGA patients who underwent a transthoracic echocardiogram (TTE), cardiac magnetic resonance (CMR) and cardiopulmonary exercise test (CPET) within one year between September 2009 and February 2024 at the University Medical Center Utrecht.

Immune Shielding of Human Heart Valves: A Proof-of-Concept Study of HLA-Targeting Therapy for Transplantations.

Children born with defective heart valves require multiple donor valve replacements throughout life, because these cannot grow and can cause early failure through immune degeneration. This study tests the lentiviral delivery of viral immune evasion genes US2 and human serpin 9 to shield human heart valves from immune rejection. The results show we can efficiently down-regulate human leukocyte antigen expression in heart valve cells and in intact heart valve tissue resulting in decreased activity of a human leukocyte antigen-reactive CD8+ T-cell clone without inducing cytotoxicity.

Anatomic and Physiologic Repair of Congenitally Corrected Transposition of the Great Arteries.

Background: Congenitally corrected transposition of the great arteries (ccTGA) is a rare cardiac anomaly. The management strategy historically consisted of physiologic repair, leaving the morphologic right ventricle to support the systemic circulation. More recently, anatomic repair has been implemented to bring the left ventricle into the systemic circulation.

Predictors of Left Ventricular Outflow Tract Obstruction After Primary Interrupted Aortic Arch Repair.

Left ventricular outflow tract obstruction is an important complication after interrupted aortic arch repair and subsequent interventions may adversely affect survival. Identification of patients at risk for obstruction is important to facilitate clinical decision-making and monitoring during follow-up. The aim of this review is to summarize reported risk factors for left ventricular outflow tract obstruction after corrective surgery for interrupted aortic arch.