INTRODUCTION:
Transposition of the great arteries (TGA) is a common cyanotic congenital heart disease either in isolation or as a part of more complex congenital cardiac anomalies. Since its inception in 1975 by Jatene, the arterial switch operation (ASO) has become the standard method for surgical repair of the TGA1,2.
The goal of surgical repair is to have an anatomical correction. Part of the surgical treatment is performing the Lecompte procedure where the pulmonary arteries are relocated anteriorly4. Furthermore, the neo-pulmonary artery is reconstructed, most often using a pericardial patch. Although the current operative mortality is low and the mid and late outcomes are satisfactory, there are still some complications, one of which is the residual pressure gradient across the pulmonary valve and reconstructed pulmonary arteries3-6.
The pressure gradient across the neo-pulmonary artery (especially in the supra-valvular area) is the most crucial determinant for reintervention, though modifications of arterial switch operation have reduced the occurrence of pulmonary stenosis4,5,7.
The reported incidence of reoperation related to pulmonary stenosis after the arterial switch operation ranges from 5-30%5,8-10. Because the pulmonary artery pressure gradient can vary with the somatic growth, we sought to examine the behavior of the pulmonary artery pressure gradient over time and to determine the contributing factors and its relationship with the need for reintervention.