TITLE:
A Prospective Observational Study on the Long-Term Fate of Neo-Aorta Following Arterial Switch Surgery
AUTHORS:
Sumanth Raghuprakash, Amitabh Satsangi, Akshay Kumar Bisoi
KEYWORDS:
ASO, TGA, NEO Aortic Regurgitation, Congenital Heart Disease
JOURNAL NAME:
World Journal of Cardiovascular Surgery,
Vol.16 No.4,
April
23,
2026
ABSTRACT: Introduction: For patients of all ages with transposition of the great arteries and its different subtypes, arterial switch surgery is the standard of care. While short-term mortality and morbidity have decreased significantly over time, long-term neoaortic regurgitation development is still a significant problem. Methodology: The study included all children who underwent primary ASO with or without integrated ECMO support, were operated on by a single surgeon at our facility, and finished at least five years of follow-up. During the course of the study, 35 patients were evaluated. The paediatric cardiologist performed the clinical examination and echocardiographic evaluation. Findings: The patients’ median age at follow-up was 10 years (range: 5 - 13 years). Girls (n = 3, 8.5%), boys (n = 32, 91%). At presentation, 31 patients (88.5%) had TGA, intact ventricular septum; 4 patients (11.5%) had TGA, VSD; 4 patients (11.4%) had moderate AR; 10 patients (28.57%) had mild AR; and 21 patients (60%) had no or trivial AR. There was no discernible dilatation in the LV dimensions of these four patients. Conclusion: Aortic regurgitation has no effect on neo aortic growth, with the exception of the annulus. Therefore, an early return of transposed arteries to their normal anatomical position results in a competent aortic valve because systemic pressure causes the valve’s cell signalling to be upregulated.