The Coronary Arteries in Adults after the Arterial Switch Operation: A Systematic Review
Coronary artery status in adults long after the arterial switch operation (ASO) is unclear. We conducted a systematic review to provide an overview of coronary complications during adulthood and to evaluate the value of routine coronary imaging in adults after ASO, in light of current guidelines. Ar...
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doaj-91e510adedbf45deb8de105ea887fcd32021-09-26T00:27:39ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252021-08-01810210210.3390/jcdd8090102The Coronary Arteries in Adults after the Arterial Switch Operation: A Systematic ReviewLeo J. Engele0Barbara J. M. Mulder1Jan W. Schoones2Philippine Kiès3Anastasia D. Egorova4Hubert W. Vliegen5Mark G. Hazekamp6Berto J. Bouma7Monique R. M. Jongbloed8Center for Congenital Heart Disease Amsterdam-Leiden (CAHAL), Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Heart Centre, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The NetherlandsCenter for Congenital Heart Disease Amsterdam-Leiden (CAHAL), Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Heart Centre, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The NetherlandsDirectorate of Research Policy, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsCenter for Congenital Heart Disease Amsterdam-Leiden (CAHAL), Department of Cardiology, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsCenter for Congenital Heart Disease Amsterdam-Leiden (CAHAL), Department of Cardiology, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsCenter for Congenital Heart Disease Amsterdam-Leiden (CAHAL), Department of Cardiology, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsCenter for Congenital Heart Disease Amsterdam-Leiden (CAHAL), Department of Cardiothoracic Surgery, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsCenter for Congenital Heart Disease Amsterdam-Leiden (CAHAL), Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Heart Centre, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The NetherlandsCenter for Congenital Heart Disease Amsterdam-Leiden (CAHAL), Department of Cardiology, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsCoronary artery status in adults long after the arterial switch operation (ASO) is unclear. We conducted a systematic review to provide an overview of coronary complications during adulthood and to evaluate the value of routine coronary imaging in adults after ASO, in light of current guidelines. Articles were screened for the inclusion of adult ASO patients and data on coronary complications and findings of coronary imaging were collected. A total of 993 adults were followed with a median available follow-up of only 2.0 years after reaching adulthood. Myocardial ischemia was suspected in 17/192 patients (8.9%). The number of coronary interventions was four (0.4%), and coronary death was reported in four (0.4%) patients. A lack of ischemia-related symptoms cannot be excluded because innervation studies indicated deficient cardiac innervation after ASO, although data is limited. Anatomical high-risk features found by routine coronary computed tomography (cCT) included stenosis (4%), acute angle (40%), kinking (24%) and inter-arterial course (11%). No coronary complications were reported during pregnancy (n = 45), although, remarkably, four (9%) patients developed heart failure. The 2020 European Society of Cardiology (ESC) guidelines state that routine screening for coronary pathologies is questionable. Based on current findings and in line with the 2018 American ACC/AHA guidelines a baseline assessment of the coronary arteries in all ASO adults seems justifiable. Thereafter, an individualized coronary follow-up strategy is advisable at least until significant duration of follow-up is available.https://www.mdpi.com/2308-3425/8/9/102transposition of the great arteriesarterial switch operationcoronary arterycoronary complicationsimaging |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Leo J. Engele Barbara J. M. Mulder Jan W. Schoones Philippine Kiès Anastasia D. Egorova Hubert W. Vliegen Mark G. Hazekamp Berto J. Bouma Monique R. M. Jongbloed |
spellingShingle |
Leo J. Engele Barbara J. M. Mulder Jan W. Schoones Philippine Kiès Anastasia D. Egorova Hubert W. Vliegen Mark G. Hazekamp Berto J. Bouma Monique R. M. Jongbloed The Coronary Arteries in Adults after the Arterial Switch Operation: A Systematic Review Journal of Cardiovascular Development and Disease transposition of the great arteries arterial switch operation coronary artery coronary complications imaging |
author_facet |
Leo J. Engele Barbara J. M. Mulder Jan W. Schoones Philippine Kiès Anastasia D. Egorova Hubert W. Vliegen Mark G. Hazekamp Berto J. Bouma Monique R. M. Jongbloed |
author_sort |
Leo J. Engele |
title |
The Coronary Arteries in Adults after the Arterial Switch Operation: A Systematic Review |
title_short |
The Coronary Arteries in Adults after the Arterial Switch Operation: A Systematic Review |
title_full |
The Coronary Arteries in Adults after the Arterial Switch Operation: A Systematic Review |
title_fullStr |
The Coronary Arteries in Adults after the Arterial Switch Operation: A Systematic Review |
title_full_unstemmed |
The Coronary Arteries in Adults after the Arterial Switch Operation: A Systematic Review |
title_sort |
coronary arteries in adults after the arterial switch operation: a systematic review |
publisher |
MDPI AG |
series |
Journal of Cardiovascular Development and Disease |
issn |
2308-3425 |
publishDate |
2021-08-01 |
description |
Coronary artery status in adults long after the arterial switch operation (ASO) is unclear. We conducted a systematic review to provide an overview of coronary complications during adulthood and to evaluate the value of routine coronary imaging in adults after ASO, in light of current guidelines. Articles were screened for the inclusion of adult ASO patients and data on coronary complications and findings of coronary imaging were collected. A total of 993 adults were followed with a median available follow-up of only 2.0 years after reaching adulthood. Myocardial ischemia was suspected in 17/192 patients (8.9%). The number of coronary interventions was four (0.4%), and coronary death was reported in four (0.4%) patients. A lack of ischemia-related symptoms cannot be excluded because innervation studies indicated deficient cardiac innervation after ASO, although data is limited. Anatomical high-risk features found by routine coronary computed tomography (cCT) included stenosis (4%), acute angle (40%), kinking (24%) and inter-arterial course (11%). No coronary complications were reported during pregnancy (n = 45), although, remarkably, four (9%) patients developed heart failure. The 2020 European Society of Cardiology (ESC) guidelines state that routine screening for coronary pathologies is questionable. Based on current findings and in line with the 2018 American ACC/AHA guidelines a baseline assessment of the coronary arteries in all ASO adults seems justifiable. Thereafter, an individualized coronary follow-up strategy is advisable at least until significant duration of follow-up is available. |
topic |
transposition of the great arteries arterial switch operation coronary artery coronary complications imaging |
url |
https://www.mdpi.com/2308-3425/8/9/102 |
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