17-year experience in surgical management of congenitally corrected transposition of the great arteries: A single-centre's experience
Journal
European Journal of Cardio-thoracic Surgery
Journal Volume
49
Journal Issue
2
Pages
522-527
Date Issued
2016
Author(s)
Abstract
OBJECTIVES: We report our surgical experience in congenitally corrected transposition of great arteries (CCTGAs) and the long-term follow-up result. METHODS: From January 1995 to February 2012, 56 patients with CCTGA received definite surgical repair; 15 patients received conventional repair (Group I), 18 patients received anatomical repair (Group II) and 23 patients received single ventricular palliation (Group III). They were followed for early and late mortality, long-term survival, postoperative morbidity and reintervention or reoperation. RESULTS: The overall survival rate was 80% at 16 years in Group I, 53% at 13 years in Group II and 100% at 13 years in Group III. After excluding the early surgical mortality, the long-term survival rate was 92% at 16 years in Group I, 64% at 13 years in Group II and 100% at 13 years in Group III. Patients with significant tricuspid valve regurgitation showed the worst outcome after surgery. CONCLUSIONS: Our series showed good results with single ventricular palliation (SVP) in CCTGA with complex anatomy, but the long-term result should be followed. Anatomical repair is the choice of operation only for those with favourable anatomy. The more complicated intracardiac repair may result in late left ventricular outflow tract obstruction, various degrees of atrioventricular block, systemic or pulmonary venous return obstruction and the lack of an ideal conduit (e.g. homograft) for Rastelli reconstruction. Therefore, we preferred SVP in patients with complex and unfavourable anatomy. ? The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
SDGs
Other Subjects
adolescent; Article; artificial heart pacemaker; atrioventricular block; bacterial endocarditis; cardiovascular mortality; complete heart block; congenitally corrected transposition of the great arteries; controlled study; female; fenestration; great vessels transposition; heart atrioventricular valve; heart failure; heart left ventricle outflow tract obstruction; heart ventricle function; human; long term survival; major clinical study; male; morbidity; outcome assessment; overall survival; pacemaker implantation; palliative therapy; paroxysmal supraventricular tachycardia; postoperative period; preoperative complication; priority journal; reoperation; surgical mortality; tricuspid valve regurgitation; tricuspid valve repair; tricuspid valve replacement; venous return; adult; child; follow up; Fontan procedure; infant; mortality; newborn; Postoperative Complications; preschool child; procedures; retrospective study; statistics and numerical data; survival analysis; Transposition of Great Vessels; treatment outcome; young adult; Adolescent; Adult; Child; Child, Preschool; Female; Follow-Up Studies; Fontan Procedure; Humans; Infant; Infant, Newborn; Male; Postoperative Complications; Reoperation; Retrospective Studies; Survival Analysis; Transposition of Great Vessels; Treatment Outcome; Young Adult
Publisher
European Association for Cardio-Thoracic Surgery
Type
journal article