Medication in adults after atrial switch for transposition of the great arteries: clinical practice and recommendations.

Heart failure is most exceptional in the long term in adults with transposition of the large (TGA), by an atrial switch. The current guidelines do not contain a clear recommendation about heart failure medication in these patients, because there is insufficient data on its usefulness. Prescribing this medication is therefore done on the basis of the doctor's personal experience.

In this study, we examined the use of these patients and examined the use of ACE/AT2 inhibitors and beta-blockers to improve survival.

Methods and results:
We examined the medication use between 2006-2014 of 150 TGA patients (median age 30 [IQR 25-35] years, 63% male) included in the CONCOR registry via 5 university medical centers using MedicijnTab, the Dutch registry of medication use in the CBS. Use of ACE/AT2 inhibitors, beta-blockers and diuretics increased with age but this was not seen in the entire cohort of both symptomatic and asymptomatic patients.

Heart failure medication is often used by patients with transposition of the great vessels and an atrial switch, although the evidence for this is limited. This study of a lower risk of symptomatic patients taking ACE/AT2 inhibitors. This support aids the use of these drugs in symptomatic, but not asymptomatic, patients.


dr. O.I. Woudstra,

Eur Heart J Cardiovasc Pharmacother. 2022 Jan