Background Pulmonary hypertension (PH) is a common complication in patients with complete dextro-transposition of the great arteries (TGA) after atrial switch (D-TGA/AS) and congenitally corrected TGA (ccTGA). In this population with subaortic right ventricles (sRVs), echocardiography is a poor screening tool for PH; implantable invasive haemodynamic monitoring (IHM) could be used for this purpose, but data are limited. The aim of this study is to report on novel uses of IHM in patients with sRV. Methods This retrospective study describes the uses of IHM, impact of IHM on heart failure hospitalisation (HFH) and device-related complications in adults with sRV from a single centre (2015–2022). Results IHM was placed in 18 patients with sRV (median age 43 (range 30–54) years, 8 female, 16 with D-TGA/AS, 2 with ccTGA); 16 had moderate or severe sRV systolic dysfunction, 13 had PH on catheterisation. IHM was used for (1) Medical therapy titration, (2) Medical management after ventricular assist device in patients with transplant-limiting PH and (3) Serial monitoring of pulmonary artery pressures without repeat catheterisations to help identify the optimal time for heart transplant referral. In follow-up (median 23 months), HFHs/year were similar to the year prior to IHM (median 0 (IQR 0–1.0) before vs 0 (0–0.8) after, p=0.984). Device migration occurred in one, without long-term sequelae. Conclusions Uses of IHM in patients with sRV are described which may minimise the need for serial catheterisations in a population where PH is prevalent. HFHs were low overall but not impacted by IHM. One device-related complication occurred without long-term consequence. Data are available upon reasonable request. The retrospective data used to support the findings of this study are restricted by the institutional review board in order to protect patient privacy. Data are available from the corresponding author for researchers who meet the criteria for access to confidential data.

中文翻译：

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植入式血流动力学监测在成人主动脉下右心室中的新用途

背景 肺动脉高压（PH）是心房转位（D-TGA/AS）和先天性矫正大动脉（ccTGA）后完全右旋大动脉（TGA）患者的常见并发症。对于患有主动脉下右心室 (sRV) 的人群，超声心动图对于 PH 的筛查工具效果不佳；植入式侵入性血流动力学监测（IHM）可用于此目的，但数据有限。本研究的目的是报告 IHM 在 sRV 患者中的新用途。方法 这项回顾性研究描述了来自单一中心（2015-2022 年）的 IHM 的使用、IHM 对心力衰竭住院 (HFH) 的影响以及 sRV 成人患者的设备相关并发症。结果 18 名 sRV 患者（中位年龄 43（范围 30-54）岁，8 名女性，16 名 D-TGA/AS，2 名 ccTGA）接受了 IHM；16 人患有中度或重度 sRV 收缩功能障碍，13 人在插管时出现 PH。IHM 用于 (1) 药物治疗滴定，(2) 对移植限制性 PH 患者使用心室辅助装置后的医疗管理，以及 (3) 连续监测肺动脉压力，无需重复插管，以帮助确定心脏移植转诊的最佳时间。在随访中（中位 23 个月），每年 HFH 与 IHM 前一年相似（前中位数 0 (IQR 0–1.0)，后中位数 0 (0–0.8)，p=0.984）。设备迁移一发生，无长期后遗症。结论 描述了 IHM 在 sRV 患者中的应用，这可能会最大限度地减少 PH 流行人群中连续插管的需要。HFH 总体较低，但不受 IHM 影响。发生了一种与设备相关的并发症，但没有产生长期后果。数据可根据合理要求提供。为了保护患者隐私，用于支持本研究结果的回顾性数据受到机构审查委员会的限制。符合访问机密数据标准的研究人员可以从通讯作者处获得数据。