Heart failure

Slow progression to heart failure, death seen in patients with d-TGA after atrial switching | Latest news for doctors, nurses and pharmacists

According to a recent study, most adults with d-loop transposition of the great arteries (d-TGA) after atrial switch surgery have a slow progression to end-stage heart failure or death.

“A simplified prediction score for adverse outcomes at 5 years is derived to help identify those most at risk,” the investigators said.

A retrospective, multicenter cohort study was conducted of adults with d-TGA and prior atrial switch surgery seen in a congenital heart center. The investigators obtained clinical data during the initial and most recent visits. The primary outcome was the composite of death, transplantation, or mechanical circulatory support (MCS).

A total of 1168 patients (age at first visit 29 years, 38% female) were followed for a median of 9.2 years. Of these, 91 (8.8% for 10 person-years) achieved the primary outcome (66 deaths, 19 transplants, and six MCS).

Patients who had sudden/arrhythmic death were younger than those who died of other causes (32.6 vs 42.4 years; p

Additionally, anterior ventricular arrhythmia, heart failure admission, complex anatomy, QRS duration >120 ms, and severe right ventricular dysfunction based on echocardiography independently predicted primary outcome within 5 years. .