Background: Long-term outcomes in adults with prior arterial switch operation (ASO) have not yet been well defined. The aim of this study is to elucidate incidence and predictors of adverse cardiac outcomes in a prospectively followed cohort of adults after their ASO. Methods: The comprehensive long-term follow up of adults with ASO is a project within the European collaboration for prospective outcome research in congenital heart disease (EPOCH). It is designed as a prospective, international multicenter cohort study. Consecutive patients (aged 16 years or more) with prior ASO will be included at 11 European tertiary care centers. Participants will be followed according to a standardized protocol following international recommendations, including standardized protocols for imaging and for exercise testing. Main outcome measures are all-cause and cardiac-related mortality, rate of cardiac re-intervention, neo-aortic dissection, myocardial infarction, stroke, infective endocarditis, sustained atrial and ventricular arrhythmias, new-onset or worsening pulmonary hypertension and new-onset heart failure. Secondary endpoints are frequency and progression of right ventricular outflow tract stenosis, neo-aortic root dilatation, neo-aortic valve regurgitation and ventricular dysfunction. The impact of demographic, anatomic (e.g. coronary artery anatomy) and functional variables on the above-mentioned outcomes, as well as quality of life and incidence of pregnancy related complications will also be assessed. Aim: The prospective, international, multicenter EPOCH-ASO study will provide a better understanding of adverse outcomes and their predictors in adults after ASO. The results of the EPOCH-ASO study may help to optimize future care of this novel patient cohort in adult cardiology.
Age range
16 Years
Sex
ALL
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Incidence of all-cause mortality
Timeframe: during a follow up of up to 20 years
Incidence of cardiac-related mortality
Timeframe: during a follow up of up to 20 years
Incidence/rate of re-intervention
Timeframe: during a follow up of up to 20 years
Incidence/rate of neo-aortic dissection
Timeframe: during a follow up of up to 20 years
Incidence of myocardial infarction
Timeframe: during a follow up of up to 20 years
Incidence of arrhythmias
Timeframe: during a follow up of up to 20 years
Incidence of new onset / worsening heart failure
Timeframe: during a follow up of up to 20 years
Incidence of stroke
Timeframe: during a follow up of up to 20 years
Incidence of infective endocarditis
Timeframe: during a follow up of up to 20 years
Incidence of pulmonary hypertension
Timeframe: during a follow up of up to 20 years