Question

Discuss long-term follow-up of children with:
Arterial switch operation for transposition of great arteries.

Hint:

Close follow-up is essential for early detection of complications like arrhythmias, left ventricular dysfunction, or pulmonary hypertension.

Answer 1

Step 1: Understanding Arterial Switch Operation (ASO):
The arterial switch operation is the gold standard procedure for treating transposition of the great arteries (TGA). In TGA, the aorta arises from the right ventricle, and the pulmonary artery arises from the left ventricle, resulting in a reversal of blood flow. The ASO involves switching the origins of the aorta and pulmonary artery to their correct positions.
Step 2: Long-Term Follow-Up After ASO:
1. Cardiac Function Monitoring: Patients require long-term follow-up to assess cardiac function, particularly for left ventricular function, as it may be affected by the procedure. Regular echocardiograms and ECGs are needed.
2. Pulmonary Arterial Pressure: Monitoring of pulmonary arterial pressures is important, as some patients may develop pulmonary hypertension.
3. Risk of Arrhythmias: There is an increased risk of arrhythmias, particularly after ASO, due to scar tissue from the surgery.
4. Growth and Development: Ensuring normal growth and development is important, as some children may experience developmental delays.
5. Psychosocial Support: Long-term psychosocial support is necessary to help patients adjust to living with a congenital heart condition.