Congenitally corrected transposition of the great arteries: Morphologic study of 32 cases

Allwork, Sally P.; Bentall, H. H.; Becker, Anton E.; Cameron, Hugh U.; Gerlis, Leon M.; Wilkinson, James L.; Anderson, Robert H.

doi:10.1016/0002-9149(76)90804-3

Cited by 243 publications

(69 citation statements)

References 40 publications

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“…11 Several features render these patients more fragile than their counterparts with atrioventricular concordance. Among these features is the propensity for atrioventricular conduction abnormalities 12 and for TV dysfunction [1][2][3] as well as the much-debated capability of the RV to function adequately in the systemic circulation over the course of a normal life span, regardless of the state of the TV. [13][14][15][16] Several investigators have reported that TV function in patients with CTGA appears to be adversely affected by surgical repair of associated lesions.…”

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

“…[1][2][3] Autopsy studies of patients with this lesion have documented TV abnormalities in 91% of cases, most commonly an Ebsteinlike anomaly with short, thickened chordae tendineae. 1,4 Clinically significant tricuspid insufficiency (TI) has been reported in 20% to 50% of patients with CTGA. 2,3,[5][6][7] In addition to the severity of the anatomic abnormality of the valve, other potential predisposing factors for the development of important TI have been proposed but not well documented.…”

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Progressive Tricuspid Valve Disease in Patients With Congenitally Corrected Transposition of the Great Arteries

et al. 1998

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Background-The outcome of patients with corrected transposition of the great arteries (CTGA) is variably affected by associated intracardiac defects, tricuspid valve competence, and systemic right ventricular (RV) function. The relative importance of these factors in long-term outcome has not been evaluated. Methods and Results-Since 1958, 40 patients with CTGA were studied to determine risk factors for poor outcome,including age, open heart surgery, tricuspid insufficiency (TI), cardiac rhythm, pulmonary overcirculation, and RV dysfunction. Follow-up ranged from 7 to 36 years (mean 20 years). Intracardiac repair was performed in 21 patients; 19 were unoperated or had closed heart procedures. For the purposes of this study the designation TI s refers to at least moderately severe TI as delineated by echocardiogram and/or angiography. TI s was the only independently significant factor for death (Pϭ0.01), and in turn, only the presence of a morphologically abnormal TV predicted TI s (Pϭ0.03). Twenty-year survival without TI s was 93%, but only 49% with TI s . Poor long-term postoperative outcome was due to TI s in all but 1 patient; 20-year survival rates for operated patients with and without TI s were 34% and 90%, respectively (Pϭ0.002). Similarly, 20-year survival rates for unoperated patients with and without TI s were 60% and 100%, respectively, whether or not attempts to repair the TI were made (Pϭ0.08). Conclusions-TI s represents the major risk factor for CTGA patients; RV dysfunction appears to be almost always secondary to long-standing TI. Decisions related to surgical interventions with or without associated lesions must be strongly influenced by the status of the tricuspid valve. (Circulation. 1998;98:997-1005.)

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Progressive Tricuspid Valve Disease in Patients With Congenitally Corrected Transposition of the Great Arteries

et al. 1998

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“…This recess could be mistakenly interpreted as tricuspid valve prolapse, a common malformation in AVD. 9 10,15 In the cases of situs solitus with dextrocardia and 414 CIRCULATION situs inversus with levocardia, the ventricular septum is perpendicular to the frontal plane, and the position of the ventricular septal defect may be identified in the conventional anteroposterior projection ( fig. SA).…”

Section: Situs Inversusmentioning

confidence: 99%

Angiographic studies of atrioventricular discordance.

Attié¹,

Soni²,

Ovseyevitz³

et al. 1980

Circulation

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SUMMARY The results and value of conventional and axial angiocardiography were studied in 26 cases of atrioventricular discordance (AVD). The angiographic anatomy of this malformation was analyzed to determine the precise characteristics of atrioventricular and ventriculoarterial connections. The left and right ventricles in atrial situs solitus and levocardia show angiographic features that differ from those seen in atrial situs solitus and dextrocardia. The same differences are found in atrial situs inversus. Regardless of the type of ventriculoarterial connections, the ventricles maintain the same angiographic characteristics. The ventricular septum in AVD in situs solitus and levocardia and situs inversus and dextrocardia has a peculiar orientation. The use of axial angiocardiography facilitates detection and localization of the ventricular septal defect. In cases of malposition of the heart, the conventional frontal view allows visualization of the ventricular septum in all of its length. The axial projection is useful in diagnosing left ventricular outflow tract obstruction.ATRIOVENTRICULAR DISCORDANCE (AVD) is a congenital heart malformation that has received very wide clinical attention in the last decades. In AVD, by definition, the morphologic right atrium is connected to the morphologic left ventricle, and the morphologic left atrium is connected to the morphologic right ventricle.' These malformations are found in situs solitus as well as in situs inversus2 ' with either a right-sided (dextrocardia) or a left-sided (levocardia) cardiac apex. Materials and Methods Twenty-six patients with AVD were selected for this study. The diagnosis was suspected clinically of the basis of chest roentgenographic and electrocardiographic findings, and was confirmed angiocardiographically in all cases.The angiocardiographic study was made by injecting Conray 400 into the ventricles in all cases. Selective injections of contrast medium into the right and left atria also were performed in eight patients. The 26 patients were studied using the standard frontal and lateral projections. Biplane "four-chamber" views were obtained in four patients.The visceral situs was determined by: (1) analyzing the P wave of the ECG, (2) delineating the position of the major lobe of the liver in the chest film and the position and connection of the systemic veins, and (3) visualizing the atria either during the levophase of the angiocardiogram or by selective left and right atriograms. Each case was further analyzed with respect to (1) the type of atrioventricular connections, (2) the anatomic features of both ventricles and (3) the ventriculoarterial connections. ResultsWe studied 13 males and 13 females, ages 21 months to 21 years. Eighteen patients had atrial situs solitus; 14 had levocardia and four had dextrocardia. The other eight patients had atrial situs inversus, including two with dextrocardia and six with levocardia. Sixteen of our patients had transposition of the great arteries (ventriculoarterial discordance), six had doub...

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“…Only 1% of these patients are without other congenital anomalies (1) Commonly associated anatomic lesions include large atrial or ventricular septal defects, pulmonary stenosis, Ebstein's anomaly and single ventricle (2). The natural history is quite variable and it is dependent on the presence and severity of associated malformations (3).…”

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Congenitally corrected transposition of the great vessels: A case of very late presentation at old age and survival till 9th decade

Olafiranye¹,

Salciccioli²,

Lazar³

2012

Anadolu Kardiyol Derg

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Congenitally corrected transposition of the great arteries: Morphologic study of 32 cases

Cited by 243 publications

References 40 publications

Progressive Tricuspid Valve Disease in Patients With Congenitally Corrected Transposition of the Great Arteries

Progressive Tricuspid Valve Disease in Patients With Congenitally Corrected Transposition of the Great Arteries

Angiographic studies of atrioventricular discordance.

Congenitally corrected transposition of the great vessels: A case of very late presentation at old age and survival till 9th decade

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