Abstract
Objective. To determine the risk factors for the development of neoaortic root dilatation in the long-term period in patients who
underwent arterial switch operation with transposition of the great arteries (TGA).
Material and methods. Morphometric characteristics of the anatomical structures of the heart and the great arteries were evaluated
in 248 patients with TGA to analyze long-term results of treatment, identify the causes and determine predictors of the development
of aortic root dilatation. A statistical analysis of the obtained data was carried out to determine the most significant risk
factors in the pre-, intra- and post-operative period, which led to the development of neo-aortic root dilatation in the late postoperative
period.
Results. Dilatation of the neoaortic root in the postoperative period was found in 85 (34.3%) patients, among them 60 males, who
accounted for 24.2%. The narrowing of the pulmonary artery before the operation of arterial switch was performed in 17 (6.9%)
patients. In the first year of observation, the incidence of this complication was in 53 patients (21.4% of all those observed), over the
next three years it was diagnosed in 22 (8.9%) patients, with further observation in 10 (4%) patients. In the long-term period, according
to multiple statistical analysis, the development of this complication was affected by the diameter of the aortic valve (p<0.001),
the diameter of the pulmonary valve (p<0.001), the duration of the artificial blood circulation during the operation (p=0.043) and
the presence of a neoaortic valve insufficiency (p=0.016).
Conclusion. The risk factors for the development of neoaortic root dilatation identified in this study demonstrate the high influence
of the anatomy and spatial relationship of the main arteries. For the timely diagnosis of this complication, it is advisable to conduct
dynamic observations in all patients with these predictors.
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About the authors
- Leo A. Bockeria, Academician of Russian Academy of Sciences and Russian Academy of Medical Sciences, Director, orcid.org/0000-0002-6180-2619;
-
Inessa E. Nefedova, Cand. Med. Sc., Head of Department, orcid.org/0000-0002-9221-051X;
-
David O. Berishvili, Dr. Med. Sc., Head of Department, orcid.org/0000-0001-7379-345X;
-
Irina Yu. Baryshnikova, Cand. Med. Sc., Researcher, orcid.org/0000-0001-8071-2531
