Corrected Transposition of the Great Vessels in a 73-Year-Old Man

Lieberson, Alan D.; Schumacher, Ralph; Childress, Richard H.; Genovese, Pasquale D.

doi:10.1161/01.cir.39.1.96

Cited by 51 publications

(8 citation statements)

References 12 publications

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“…It is known that atrioventricular discordance (also called corrected transposition) may be compatible with a normal life span when there is no other significant abnormality [1,7] . However, congenital cardiac defects associated with atrioventricular discordance affect the clinical presentation and outcome [2,4] .…”

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confidence: 99%

Survival in atrioventricular discordance

et al. 1985

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Limited information is available concerning the long-term survival of patients with atrioventricular discordance, ventriculoarterial discordance, and two ventricles (corrected transposition). The long-term follow-up of 107 patients examined at the Mayo Clinic over a 30-year period between 1951 and 1981 was reviewed. Overall survival from the date of Mayo Clinic diagnosis was 70% at five years and 64% at ten years. Associated variables were analyzed for their effect on survival including sex, age at diagnosis, presence of ventricular septal defect, pulmonary stenosis, dextrocardia, left atrioventricular valve insufficiency, and complete heart block. There was no significant difference between those with and without a ventricular septal defect (VSD). Pulmonary stenosis was protective when a VSD was present but was not a significant predictor of long-term survival. The only variable that consistently correlated with decreased survival was left atrioventricular valve insufficiency (p less than 0.04 for univariate and stepwise Cox, and p = 0.08 for multivariate analysis). A logistic model for survival after open-heart surgery failed to identify any significant variable. We conclude that the presence of left atrioventricular valve insufficiency in association with atrioventricular discordance significantly alters the long-term outcome. Atrioventricular valve replacement should be considered in such patients when insufficiency becomes hemodynamically significant.

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confidence: 99%

Survival in atrioventricular discordance

et al. 1985

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“…Congenitally corrected transposition of the great arteries is a rare cardiac malformation which has a unique pathology as well as variable clinical presentation even in the seventh decade of life . The natural history and clinical presentation of the cases with cc‐TGA are closely related to the coexistence of a ventricular septal defect, which is reported to be the most commonly associated congenital heart defect in these patients .…”

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Double Switch Procedure and Surgical Alternatives for the Treatment of Congenitally Corrected Transposition of the Great Arteries

et al. 2016

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“…Pathologic reviews at autopsy of patients with ccTGA revealed systemic AV valve anomalies in 91-97% of cases and a VSD in 78%. 3,4 Though some patients without associated anomalies may not be diagnosed until later in life, [5][6][7] patients with ccTGA often present in infancy or childhood with symptoms of congestive heart failure secondary to a VSD. 8 Surgical planning for patients with ccTGA is related to the presence of a VSD, pulmonary stenosis, and the state of the right ventricle.…”

Section: Discussionmentioning

confidence: 99%

Congenitally Corrected Transposition of the Great Arteries and Concomitant Coronary Artery and Valvular Disease in the Adult Patient

Stern

Steiner

Bello

et al. 2010

Congenital Heart Disease

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Congenitally corrected transposition of the great arteries (ccTGA) accounts for less that 1% of cardiac anomalies, and is defined as ventriculoarterial and atrioventricular (AV) discordance. The double discordant connection allows for survival with the right ventricle performing as the systemic ventricle, and the left ventricle as the pulmonary ventricle. We report a case of ccTGA in a 35-year-old male with situs inversus totalis status post repair of a ventricular septal defect (VSD) with a residual VSD, severe systemic AV valve regurgitation, and coronary artery disease who presented with chest pain. He subsequently underwent tricuspid valve replacement and VSD repair, followed by percutaneous coronary revascularization. This case highlights many important issues of adults with congenital cardiac disease, as well as the specific surgical management of anomalies associated with ccTGA. We review the literature and discuss the management of these complicated patients.

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Corrected Transposition of the Great Vessels in a 73-Year-Old Man

Cited by 51 publications

References 12 publications

Survival in atrioventricular discordance

Survival in atrioventricular discordance

Double Switch Procedure and Surgical Alternatives for the Treatment of Congenitally Corrected Transposition of the Great Arteries

Congenitally Corrected Transposition of the Great Arteries and Concomitant Coronary Artery and Valvular Disease in the Adult Patient

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