Long-term outcome in congenitally corrected transposition of the great arteries

Graham, T.P.; Bernard, Yvonne; Mellen, Beverly G.; Celermajer, David S.; Baumgartner, Helmut; Cetta, Frank; Connolly, Heidi M.; Davidson, William R.; Dellborg, Mikael; Foster, Elyse; Gersony, Welton M.; Gessner, Ira H.; Hurwitz, Roger A.; Kaemmerer, Harald; Kugler, John D.; Murphy, Daniel J.; Noonan, Jacqueline A.; Morris, Cynthia D.; Perloff, Joseph K.; Sanders, Stephen P.; Sutherland, James L.

doi:10.1016/s0735-1097(00)00682-3

Cited by 612 publications

(381 citation statements)

References 28 publications

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“…Given that patients without significant associated intracardiac lesions could remain asymptomatic for a long period,1, 2, 3, 4, 5 these patients can be unrecognized until their adulthood, especially in developing countries like China. Meanwhile, even if they are diagnosed in early childhood, more surgeons tend not to intervene surgically in the absence of hemodynamic lesions, but closely monitor them instead 6, 7.…”

Section: Introductionmentioning

confidence: 99%

Long‐Term Outcomes of Tricuspid Valve Surgery in Patients With Congenitally Corrected Transposition of the Great Arteries

Deng

Tang

et al. 2018

JAHA

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BackgroundValvuloplasty is generally considered unsuccessful in patients with congenitally corrected transposition of the great arteries. Optimal timing of tricuspid valve surgery in these patients is crucial.Methods and ResultsWe retrospectively reviewed 57 patients with congenitally corrected transposition of the great arteries undergoing tricuspid valve surgery at our institution. Eleven patients had tricuspid valve plasty and 46 had tricuspid valve replacement. Mean duration of follow‐up was 7.4±5.5 years in the group of tricuspid valve plasty and 5.6±3.6 years in the group of tricuspid valve replacement, respectively (P=0.33). For the total of 57 patients, estimates of 1‐, 5‐, and 10‐year survival or freedom from transplantation were 96.4%, 91.6%, and 75.6%, respectively. Late right ventricular ejection fraction of most patients (90%) remained preserved (≥40%) during the follow‐up. In a highly selected group of tricuspid valve plasty recipients, although long‐term survival and right ventricular function were similar compared with tricuspid valve replacement, recurrent tricuspid regurgitation was observed in 60% of these patients. Multivariate Cox regression analysis identified preoperative right ventricular end‐diastolic dimension (1‐cm increment; harzard ratio, 3.22; P=0.02) as an independent predictor of postoperative mortality or need for transplantation. Patients undergoing surgery with a right ventricular end‐diastolic dimension ≥60 mm had a significant lower survival rate compared with those with a right ventricular end‐diastolic dimension <60 mm (P=0.003).ConclusionsTricuspid valve surgery in patients with congenitally corrected transposition of the great arteries could yield satisfactory long‐term outcomes. Recurrent tricuspid regurgitation was frequently observed in tricuspid valve plasty recipients. Preoperative right ventricular end‐diastolic dimension was a risk factor for late mortality and surgery should be performed before cardiac enlargement and dysfunction for best outcomes.

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Section: Introductionmentioning

confidence: 99%

Long‐Term Outcomes of Tricuspid Valve Surgery in Patients With Congenitally Corrected Transposition of the Great Arteries

Deng

Tang

et al. 2018

JAHA

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“…The fundamental cause of morbidity and mortality in ccTGA appears to be more related to a gradual deterioration in systemic right ventricular function 22. The reasons for this are multifactorial in etiology, but increasingly long‐term single‐site ventricular pacing is recognized as a factor 23.…”

Section: Cardiac Conduction Disorders In Cctgamentioning

confidence: 99%

“…There is also a tendency of AV conduction defects to progress with age, and the incidence of complete AV block in older children and adults with ccTGA is 30% to 38% 5, 27. The risk of developing de novo AV block is ≈2%/y 22. For this reason, patients with ccTGA should be followed closely with annual ECG and ambulatory monitoring (even in the absence of symptoms); and cardiopulmonary stress testing can be useful (class IIa) to detect subtle deterioration in the infranodal conduction tissue that will block with faster heart rates 28, 29, 30…”

Section: Management Of Conduction Disorders In Cctgamentioning

confidence: 99%

“…Finally it has become impossible to imagine a future of pacing without leadless systems and more importantly without biological therapies43, 44 that can restore automaticity or conduction so that current transvenous and epicardial systems become obsolete. This latter innovation is especially attractive for those patients with ccTGA, as they frequently require pacing at a much younger age than the conventional patient with AV block22 and therefore have many more years exposed to the risks of intravascular leads and generator replacement surgeries.…”

Section: Future Directions and Conclusionmentioning

confidence: 99%

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Cardiac Conduction System in Congenitally Corrected Transposition of the Great Arteries and Its Clinical Relevance

Baruteau

Abrams

et al. 2017

JAHA

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“…Co n t r a s t -e n h a n c e d t h r e e d i me n s i o n a l CT s c a n s (1,2), and three-dimensional CT scan is useful in its diagnosis.…”

Section: P I C T U R E 1 Ap I C a L L O N G A X I S V I E W O F L Ementioning

confidence: 99%

Congenitally Corrected Transposition of Great Arteries in 76-year-old Woman

et al. 2010

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Long-term outcome in congenitally corrected transposition of the great arteries

Cited by 612 publications

References 28 publications

Long‐Term Outcomes of Tricuspid Valve Surgery in Patients With Congenitally Corrected Transposition of the Great Arteries

Long‐Term Outcomes of Tricuspid Valve Surgery in Patients With Congenitally Corrected Transposition of the Great Arteries

Cardiac Conduction System in Congenitally Corrected Transposition of the Great Arteries and Its Clinical Relevance

Congenitally Corrected Transposition of Great Arteries in 76-year-old Woman

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