PT  - JOURNAL ARTICLE
AU  - Teun van der Bom
AU  - Roel L F van der Palen
AU  - Berto J Bouma
AU  - Sophie L van Veldhuisen
AU  - Hubert W Vliegen
AU  - Thelma C Konings
AU  - Aeilko H Zwinderman
AU  - Nico A Blom
AU  - Dave R Koolbergen
AU  - Mark G Hazekamp
AU  - Barbara J M Mulder
TI  - Persistent neo-aortic growth during adulthood in patients after an arterial switch operation
AID  - 10.1136/heartjnl-2014-305702
DP  - 2014 Sep 01
TA  - Heart
PG  - 1360--1365
VI  - 100
IP  - 17
4099  - http://heart.bmj.com/content/100/17/1360.short
4100  - http://heart.bmj.com/content/100/17/1360.full
SO  - Heart2014 Sep 01; 100
AB  - Objective After the arterial switch operation (ASO), disproportional neo-aortic growth during childhood has been reported. Even though it has been suggested neo-aortic dilation will stabilise in adulthood, data are lacking. The aim of this study was to assess the change in neo-aortic dimensions, prevalence of neo-aortic dilation >40 mm and long-term outcome in adults who underwent ASO in childhood. Methods All 116 ASO patients operated in a tertiary referral centre and born before 1995 were included. Of these, 83 (72%) survived to adulthood (>17 years) and six were lost to follow-up. Neo-aortic measurements performed in adulthood were collected from available echocardiographic, cardiovascular magnetic resonance and CT images. The time trend was analysed using a mixed model, adjusted for imaging modality. Results Clinical data with at least one measurement of the neo-aortic diameter were available in 77 (93%) adult patients and serial measurements in 65 (78%). At baseline (median age 18.1 years), mean neo-aortic diameter was 36±5 mm. Mean neo-aortic growth was 0.31 mm/year (p<0.001 compared with normal value 0.08 mm/year) and was linear over time. Freedom from neo-aortic dilation beyond a diameter of 40 mm was 23% at 28 years of age. During a mean clinical follow-up in adulthood of 7.2 years (IQR 4.0 to 10.1), 3 (4%) patients underwent neo-aortic replacement. No other neo-aortic complications occurred. Conclusions In early adulthood, neo-aortic growth was on average linear and did not stabilise over time.