Evidence map›Paper›PMID 40701798›Full record

ArticleHeart (British Cardiac Society)2026

Aortic coarctation and long-term morbidity after arterial switch operation: a multicentre international cohort study.

Francisco Javier Ruperti-Repilado, Raquel Ladrón, Pedro Lopez-Ayala, Beshoy Gabra, Victor González-Fernández, Leo J Engele, Begoña Manso, Berto J Bouma, Harald Gabriel, Fabienne Schwitz and 10 more

Registry-linked trialAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Heart (British Cardiac Society), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04335448 (Comprehensive Long-term Follow up of Adults With Arterial Switch Operation - European Collaboration for Prospective Outcome Research in Congenital Heart Disease), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04335448 active not recruitingnot on this map

Comprehensive Long-term Follow up of Adults With Arterial Switch Operation - European Collaboration for Prospective Outcome Research in Congenital Heart Disease

Typeobservational_patient_registrySponsorUniversity of ZurichRan2019 to 2039Enrolled540ConditionsTransposition of Great VesselsArmsNo intervention is planed
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Francisco Javier Ruperti-Repilado *Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland javier.ruperti@usb.ch.ORCID 0000-0002-9904-0402
Raquel Ladrón *Virgen del Rocio University Hospital, Seville, Spain.ORCID 0000-0003-1312-9068
Pedro Lopez-AyalaCardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland.ORCID 0000-0002-7787-0640
Beshoy GabraDepartment of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.
Victor González-FernándezUnitat Integrada de Cardiopaties Congènites de l'Adolescent i Adult, Vall d'Hebron University Hospital, Barcelona, Spain.
Leo J EngeleCardiology, Amsterdam UMC Location AMC, Amsterdam, The Netherlands.
Begoña MansoVirgen del Rocio University Hospital, Seville, Spain.
Berto J BoumaCardiology, Amsterdam UMC Location AMC, Amsterdam, The Netherlands.ORCID 0000-0002-1433-9692
Harald GabrielAdult Congenital Heart Disease Program, Medical University of Vienna Division of Cardiology, Vienna, Austria.
Fabienne SchwitzDepartment of Cardiology, Inselspital University Hospital Bern, Bern, Switzerland.
Mathias PossnerDepartment of Cardiology, Inselspital University Hospital Bern, Bern, Switzerland.
Markus SchwerzmannUniversity of Bern, Bern, Switzerland.
Joaquín RuedaAdult Congenital Heart Disease Unit, Department of Cardiology, La Fe University and Polytechnic Hospital, Valencia, Spain.ORCID 0000-0002-6187-9317
Francisco Buendía-FuentesAdult Congenital Heart Disease Unit, Department of Cardiology, La Fe University and Polytechnic Hospital, Valencia, Spain.
Judith BouchardyDepartment of Cardiology and Cardiac Surgery, Lausanne University Hospital, Lausanne, Switzerland.
Magalie LadouceurDepartment of Cardiology and Cardiac Surgery, Lausanne University Hospital, Lausanne, Switzerland.ORCID 0000-0002-4325-3521
Laura Dos-SubiràUnitat Integrada de Cardiopaties Congènites de l'Adolescent i Adult, Vall d'Hebron University Hospital, Barcelona, Spain.ORCID 0000-0001-5821-4501
Matthias GreutmannDepartment of Cardiology, University Hospital Zurich, Zurich, Switzerland.ORCID 0000-0002-8692-6108
Daniel Tobler *Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.
Pastora Gallego *Adult Congenital Heart Disease Unit, Virgen del Rocio University Hospital Cardiology and Cardiovascular Surgery Service, Sevilla, Spain.ORCID 0000-0003-2115-5047

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn patients with dextro-transposition of the great arteries, cardiovascular interventions and complications are common after the arterial switch operation (ASO). While complex anatomy-typically defined by ventricular septal defects (VSDs)-is often linked to these outcomes, the independent role of aortic coarctation (CoA) remains unclear.

methodsWe analysed 502 adults from the EPOCH (European collaboration for Prospective Outcome research in Congenital Heart disease)-ASO multicentre registry (median age 25.5 years). The primary outcome was time to first right ventricular outflow tract (RVOT)-related intervention. Secondary outcomes included left ventricular outflow tract (LVOT)-related interventions and cardiovascular complications. Associations were assessed using adjusted Cox regression and Andersen-Gill models.

resultsCoA emerged as the strongest independent predictor of RVOT interventions (HR 2.62), LVOT interventions (HR 10.75) and cardiovascular complications (HR 2.16). In contrast, VSD (complex anatomy) showed weaker or no associations. CoA also predicted higher recurrence rates of both RVOT and LVOT interventions.

conclusionsAmong adults post-ASO, CoA-not VSD-is the dominant anatomical driver of long-term morbidity. These patients require targeted surgical attention and structured, lifelong follow-up to mitigate future complications. TRIAL REGISTRATION NUMBER: NCT04335448.

Indexed as

Aortic CoarctationArterial Switch OperationPostoperative ComplicationsTransposition of Great VesselsAdolescentAdultEuropeFemaleFollow-Up StudiesHumansMaleProspective StudiesRegistriesRisk FactorsTime FactorsYoung AdultAortic CoarctationTransposition of Great Vessels

Identifiers

PMID40701798
PMCPMC13151519

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.