@Article{chd.2023.025853,
AUTHOR = {Norman Aiad, Mark V. Sherrid, Adam J. Small, Youssef Elnabawi, Jodi Feinberg, Leon Axel, Ralph Mosca, T. K. Susheel Kumar, Michael Argilla, Dan G. Halpern},
TITLE = {Anatomic Correlates of Mitral Systolic Anterior Motion in Transposition of the Great Arteries Following Atrial Switch Operation},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {18},
YEAR = {2023},
NUMBER = {3},
PAGES = {267--277},
URL = {http://www.techscience.com/schd/v18n3/53115},
ISSN = {3071-1738},
ABSTRACT = { <b>Introduction:</b> We sought to investigate whether the development of sub-pulmonic systolic anterior motion (SAM) may be inherent to the anatomy of the the mitral valve (MV) or affected by external factors, such as a dilated right ventricle or chest abnormalities in d-looped transposition of the great arteries post atrial switch operation (d-TGA/AtS). <b>Methods:</b> Analysis was performed of clinical and cardiac imaging studies acquired on 19 adult patients with d-TGA/AtS (age 42 ± 6 years old, 56% male) between 2015–2019. Echocardiography data included mitral apparatus anatomy, and CT/MRI data included biventricular dimensions, function, and Haller index (HI) for pectus deformity. <b>Results:</b> Patients with leaflet SAM (n = 6) compared to patients without SAM (n = 13) had higher MV protrusion height (2.3 ± 0.5 <i>vs</i>. 1.5 ± 0.4 cm, <i>p</i> ≤ 0.01) and longer anterior MV leaflet length (3.1 ± 0.4 cm <i>vs</i>. 2.6 ± 0.3 cm <i>p</i> ≤ 0.05), when compared to those without. CT/MRI showed higher sub-pulmonic left ventricular ejection fraction (LVEF) in the SAM group (71% ± 8% <i>vs</i>. 54% ± 7%, respectively). RV size and function, significant chest deformity (HI > 3.5), presence of a ventricular lead pacemaker, and septal thickness did not play a role in development of SAM. <b>Conclusions:</b> An elongated mitral apparatus is associated with the development of SAM, and the development of left ventricular outflow tract obstruction (LVOTO), in d-TGA/AtS. LV hyperkinesia is associated with SAM. Systemic RV dimensions, septal thickness, and degree of chest deformity did not differ significantly between subjects with SAM and those without.},
DOI = {10.32604/chd.2023.025853}
}