{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T03:35:59Z","timestamp":1792812959927,"version":"4.5.0"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2013,1,22]]},"abstract":"<jats:sec>\n                    <jats:title>Background\u2014<\/jats:title>\n                    <jats:p>Data regarding long-term outcomes after the arterial switch operation for D-transposition of the great arteries are scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results\u2014<\/jats:title>\n                    <jats:p>\n                      A single-institution retrospective cohort study was conducted to assess cardiovascular outcomes after an arterial switch operation between 1983 and 1999. Patients without follow-up visits within 3 years were contacted and secondary sources of information obtained. Overall, 400 patients, 154 (38.3%) with a ventricular septal defect, 238 (59.5%) with an intact septum, and 9 (2.3%) with a Taussig-Bing anomaly, were followed for a median of 18.7 years. In perioperative survivors, overall and arrhythmia-free survival rates at 25 years were 96.7\u00b11.8% and 96.6\u00b10.1%, respectively. Late mortality was predominantly a result of sudden deaths and myocardial infarction. At 25 years, 75.5\u00b12.5% remained free from surgical or catheter-based reintervention. Freedom from an adverse cardiovascular event was 92.9\u00b11.9% at 25 years. Independent predictors were a single right coronary artery (hazard ratio, 4.58; 95% confidence interval, 1.32-15.90),\n                      <jats:italic>P<\/jats:italic>\n                      =0.0166) and postoperative heart failure (hazard ratio, 6.93; 95% confidence interval, 1.57-30.62;\n                      <jats:italic>P<\/jats:italic>\n                      =0.0107). At last follow-up, the left ventricular ejection fraction was 60.3\u00b18.9%, 97.3% had class I symptoms, and 5.2% obstructive coronary artery disease. Peak oxygen uptake was 35.1\u00b17.6 mL\/kg\/min (86.1\u00b115.1% predicted), with a chronotropic index &lt;80% in 34.2%. At least moderate neoaortic and pulmonary regurgitation were present in 3.4% and 6.6%, respectively, and more than mild neoaortic and pulmonary stenosis in 3.2% and 10.3%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\u2014<\/jats:title>\n                    <jats:p>Long-term and arrhythmia-free survival is excellent after arterial switch operation. Although sequelae include chronotropic incompetence and neoaortic, pulmonary, and coronary artery complications, most patients maintain normal systolic function and exercise capacity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.112.135046","type":"journal-article","created":{"date-parts":[[2012,12,13]],"date-time":"2012-12-13T20:39:00Z","timestamp":1355431140000},"page":"331-339","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":321,"title":["Cardiovascular Outcomes After the Arterial Switch Operation for D-Transposition of the Great Arteries"],"prefix":"10.1161","volume":"127","author":[{"given":"Paul","family":"Khairy","sequence":"first","affiliation":[{"name":"From the Departments of Cardiology and Cardiac Surgery, Boston Children\u2019s Hospital, Harvard Medical School, Boston, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathieu","family":"Clair","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiology and Cardiac Surgery, Boston Children\u2019s Hospital, Harvard Medical School, Boston, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan M.","family":"Fernandes","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiology and Cardiac Surgery, Boston Children\u2019s Hospital, Harvard Medical School, Boston, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth D.","family":"Blume","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiology and Cardiac Surgery, Boston Children\u2019s Hospital, Harvard Medical School, Boston, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Powell","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiology and Cardiac Surgery, Boston Children\u2019s Hospital, Harvard Medical School, Boston, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane W.","family":"Newburger","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiology and Cardiac Surgery, Boston Children\u2019s Hospital, Harvard Medical School, Boston, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Landzberg","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiology and Cardiac Surgery, Boston Children\u2019s Hospital, Harvard Medical School, Boston, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"John E.","family":"Mayer","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiology and Cardiac Surgery, Boston Children\u2019s Hospital, Harvard Medical School, Boston, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200002033420507"},{"key":"e_1_3_4_3_2","first-page":"966","article-title":"Surgical correction of transposition of the great vessels.","volume":"45","author":"Senning A","year":"1959","unstructured":"Senning A. 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