An Analysis of Left Ventricular Retraining in Patients With Dextro- and Levo-Transposition of the Great Arteries

Mainwaring and colleagues retrospectively reviewed the outcomes for 51 patients with transposition of the great arteries (TGA) who were enrolled in a left ventricle (LV) retraining program in preparation for an arterial switch procedure. Retraining was successful in 52% of patients with D-TGA and 92% of patients with L-TGA. Of patients who had successful retraining and underwent an arterial switch operation, the procedure was successful for 77% of patients with D-TGA and 100% with L-TGA. To quantify the LV response to training, the authors calculated an “LV retraining ratio” based on the change in the LV/RV pressure ratio in response to the first pulmonary artery banding. This ratio correlated with the presence or absence of heart failure and accurately predicted the ultimate success of retraining in 95% of patients.