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Primary care management of patients with common arterial trunk and transposition of the great arteries*

  • Jeffrey R. Boris (a1)

Primary care cardiology, also known as ambulatory or outpatient cardiology, for the longitudinal management of patients with common arterial trunk or with transposition of the great arteries is both poorly described and has limited evidence to justify its basis. This article discusses some of the various complications that these patients can develop, reviews the medical literature, and describes a framework for care of these complex patients from infancy to transition to adult congenital cardiac specialist care.

Corresponding author
Correspondence to: Dr J. R. Boris, MD, Clinical Associate Professor of Paediatrics, Division of Cardiology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, Pennsylvania 19104, United States of America. Tel: +1 215 590 3189; Fax: +1 267 426 5324; E-mail:
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Presented at: 12th Annual International Symposium on Congenital Heart Disease, February 17–21, 2012, All Children's Hospital, Saint Petersburg, Florida, United States of America.

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This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

1. G Wernovsky , JJ Rome , S Tabbutt , et al. Guidelines for the outpatient management of complex congenital heart disease. Congenit Heart Dis 2006; 1: 1026.

3. S Talwar , D Malankar , SK Choudhary , A Saxena , B Airan . An alternative technique for the atrial switch operation for transposition of the great arteries in an unoperated adult patient. J Card Surg 2010; 25: 406409.

4. RL Washington , JT Bricker , BS Alpert , et al. Guidelines for exercise testing in the pediatric age group. From the Committee on Atherosclerosis and Hypertension in Children. Council on Cardiovascular Disease in the Young, the American Heart Association. Circulation 1994; 90: 21662179.

5. W Li , TS Hornung , DP Francis , et al. Relation of biventricular function quantified by stress echocardiography to cardiopulmonary exercise capacity in adults with Mustard (atrial switch) procedure for transposition of the great arteries. Circulation 2004; 110: 13801386.

6. NC Poirier , JH Yu , CP Brizard , RB Mee . Long-term results of left ventricular reconditioning and anatomic correction for systemic right ventricular dysfunction after atrial switch procedures. J Thorac Cardiovasc Surg 2004; 127: 975981.

8. SN Weindling , G Wernovsky , SD Colan , et al. Myocardial perfusion, function and exercise tolerance after the arterial switch operation. J Am Coll Cardiol 1994; 23: 424433.

9. LE Sterrett , MS Schamberger , ES Ebenroth , AR Siddiqui , RA Hurwitz . Myocardial perfusion and exercise capacity 12 years after arterial switch surgery for D-transposition of the great arteries. Pediatr Cardiol 2011; 32: 785791.

10. C Rickers , K Sasse , R Buchert , et al. Myocardial viability assessed by positron emission tomography in infants and children after the arterial switch operation and suspected infarction. J Am Coll Cardiol 2000; 36: 16761683.

12. L Hui , AK Chau , MP Leung , CS Chiu , YF Cheung . Assessment of left ventricular function long term after arterial switch operation for transposition of the great arteries by dobutamine stress echocardiography. Heart 2005; 91: 6872.

13. RW Yates , PK Marsden , RD Badawi , et al. Evaluation of myocardial perfusion using positron emission tomography in infants following a neonatal arterial switch operation. Pediatr Cardiol 2000; 21: 111118.

14. G Oskarsson , E Pesonen , P Munkhammar , S Sandström , P Jögi . Normal coronary flow reserve after arterial switch operation for transposition of the great arteries: an intracoronary Doppler guidewire study. Circulation 2002; 106: 16961702.

16. KG Friedman , RH Rathod , M Farias , et al. Resource utilization after introduction of a standardized clinical assessment and management plan. Congenit Heart Dis 2010; 5: 374381.

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Cardiology in the Young
  • ISSN: 1047-9511
  • EISSN: 1467-1107
  • URL: /core/journals/cardiology-in-the-young
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