Document Detail


A case series of systemic right ventricular dysfunction post atrial switch for simple D-transposition of the great arteries: the impact of beta-blockade.
MedLine Citation:
PMID:  16835671     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Patients with atrial switch (Mustard or Senning) repair of D-transposition of the great arteries (D-TGA) are at increased risk for atrial arrhythmias, systemic right ventricular (RV) dysfunction and late mortality. OBJECTIVES: To evaluate case series from a single-centre experience with beta-blocker use in adult, post atrial switch, simple D-TGA patients. METHODS: The Adult Congenital Heart Disease Clinic (Halifax, Nova Scotia) database was used to identify patients with post atrial switch, simple D-TGA. Treatment effect of beta-blockade was evaluated. RESULTS: Eight patients were treated with beta-blockers for systemic RV dysfunction (n=2), arrhythmia (n=2) or both (n=4). Median follow-up was three years, at which time seven of eight patients were still on beta-blockade. Of those patients with complete data, two of five had improved systemic ventricular dysfunction, two of four had improved tricuspid regurgitation and four of six had improved functional capacity, as determined by history or exercise testing. Beta-blockade was well tolerated in seven of eight patients without any significant clinical deterioration. CONCLUSIONS: Beta-blockade was used infrequently in patients with a prior Mustard procedure. When beta-blockade was prescribed to patients with a prior atrial switch procedure, the drugs were well tolerated and were associated with trends toward improved symptoms, less tricuspid regurgitation and improved functional status in patients with reduced systemic RV function. These data support the need for a randomized trial of beta-blockade in patients with a previous Mustard or Senning operation and RV dysfunction.
Authors:
Colin B Josephson; Jonathan G Howlett; Simon D Jackson; John Finley; Catherine M Kells
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  22     ISSN:  0828-282X     ISO Abbreviation:  Can J Cardiol     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-07-12     Completed Date:  2006-08-29     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  769-72     Citation Subset:  IM    
Affiliation:
Department of Medicine, Dalhousie University, Halifax, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use*
Adult
Cardiac Surgical Procedures / adverse effects*
Echocardiography
Female
Follow-Up Studies
Heart Atria / abnormalities,  surgery*,  ultrasonography
Heart Rate / drug effects
Humans
Male
Myocardial Contraction / drug effects
Postoperative Period
Time Factors
Transposition of Great Vessels / surgery*
Treatment Outcome
Ventricular Dysfunction, Right / drug therapy*,  etiology,  physiopathology
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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