van Wijk Sebastiaan W, Driessen Mieke M, Meijboom Folkert J, Doevendans Pieter A, Schoof Paul H, Breur Hans M, Takken Tim
1Department of Paediatric Cardiology,Wilhelmina Children's Hospital,University Medical Centre Utrecht,The Netherlands.
2Department of Cardiology,University Medical Centre Utrecht,The Netherlands.
Cardiol Young. 2018 Jul;28(7):895-902. doi: 10.1017/S1047951117001032.
The arterial switch operation for transposition of the great arteries was initially believed to be an anatomical correction. Recent evidence shows reduced exercise capacity and left ventricular function in varying degrees in the long term after an arterial switch operation.
To perform a meta-analysis on long-term exercise capacity and left ventricular ejection fraction after an arterial switch operation.
A literature search was performed to cover all studies on patients who had undergone a minimum of 6 years of follow-up that reported either left ventricular ejection fraction, peak oxygen uptake, peak workload, and/or peak heart rate. A meta-analysis was performed if more than three studies reported the outcome of interest.
A total of 21 studies reported on the outcomes of interest. Oxygen uptake was consistently lower in patients who had undergone an arterial switch operation compared with healthy controls, with a pooled average peak oxygen uptake of 87.5±2.9% of predicted. The peak heart rate was also lower compared with that of controls, at 92±2% of predicted. Peak workload was significantly reduced in two studies. Pooled left ventricular ejection fraction was normal at 60.7±7.2%.
Exercise capacity is reduced and left ventricular ejection fraction is preserved in the long term after an arterial switch operation for transposition of the great arteries.
大动脉转位的动脉调转手术最初被认为是一种解剖学矫正手术。近期证据表明，动脉调转手术后长期来看，运动能力和左心室功能会有不同程度的下降。
对动脉调转手术后的长期运动能力和左心室射血分数进行荟萃分析。
进行文献检索，涵盖所有对至少随访6年的患者进行研究的报告，这些研究报告了左心室射血分数、峰值摄氧量、峰值工作量和/或峰值心率。如果有超过三项研究报告了感兴趣的结果，则进行荟萃分析。
共有21项研究报告了感兴趣的结果。与健康对照组相比，接受动脉调转手术的患者摄氧量持续较低，平均峰值摄氧量为预测值的87.5±2.9%。与对照组相比，峰值心率也较低，为预测值的92±2%。两项研究中峰值工作量显著降低。汇总的左心室射血分数正常，为60.7±7.2%。
大动脉转位的动脉调转手术后长期来看运动能力下降，左心室射血分数得以保留。
