Pathologic anatomy of corrected transposition of the great arteries: Medical and surgical implications

Praagh, Richard Van; Papagiannis, John; Grünenfelder, Jürg; Bartram, Ulrike; Martanovič, P

doi:10.1016/s0002-8703(98)70035-3

Cited by 112 publications

(55 citation statements)

References 39 publications

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“…The AV node and His bundle are congenitally displaced, with compromised function in patients with L-TGA, particularly those with Down syndrome. [142][143][144] Complete AV block occurs at birth in 3% to 5% of patients with L-TGA, and because of anterosuperior displacement of the AV node, progressive deterioration of the conduction system occurs in older adult patients with L-TGA, with an estimated 2% yearly risk of complete heart block 145 or an additional 20% incidence of AV block by adulthood. 145,146 Surgical trauma can further exacerbate compromised AV conduction.…”

Section: Sinoatrial Node Dysfunctionmentioning

confidence: 99%

Congenital Heart Disease in the Older Adult

Bhatt¹,

Foster²,

Kuehl³

et al. 2015

Circulation

205

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Section: Sinoatrial Node Dysfunctionmentioning

confidence: 99%

Congenital Heart Disease in the Older Adult

Bhatt¹,

Foster²,

Kuehl³

et al. 2015

Circulation

205

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“…This mechanism is understandable because in the normal heart the septal leaflet provides an extensive surface for leaflet coaptation. 22 Of interest, even those in group N appear to have more intrinsic prolapse than control subjects, although it did not reach statistical significance. Whether this is acquired or a component of the TV at birth in HLHS is unclear.…”

Section: Pm and Leaflet Abnormalitiesmentioning

confidence: 82%

Real-Time 3-Dimensional Echocardiography Provides New Insight Into Mechanisms of Tricuspid Valve Regurgitation in Patients With Hypoplastic Left Heart Syndrome

et al. 2009

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Background-Tricuspid regurgitation in hypoplastic left heart syndrome has an impact on outcome, but its mechanisms remain unclear. Methods and Results-Real-time 3-dimensional echocardiography was performed in 35 patients with hypoplastic left heart syndrome (age, 1 month to 10 years; 10 after first-stage Norwood, 12 after superior cavopulmonary shunt, 13 after Fontan). From the 3-dimensional data set, we marked the annulus in systole and diastole. At mid systole, we marked the location of the papillary muscle tip and point of chordal attachment to the leaflet. We traced the surfaces of the tricuspid valve leaflets and measured the volume of leaflet prolapse, tethering, annular and septal leaflet areas, and papillary muscle position. Seventeen patients had moderate tricuspid regurgitation (prolapse, 7; tethered leaflets, 7) and 18 mild (prolapse, 0; tethered leaflets, 7). Multiple linear regression analysis revealed that moderate tricuspid regurgitation is associated with leaflet tethering and prolapse; that in hypoplastic left heart syndrome with tethered leaflets, the papillary muscle is displaced laterally and the tricuspid annulus is more planar; and that enlargement of the annulus at mid systole, small septal leaflet area, and age affect the degree of prolapse. Conclusion-In hypoplastic left heart syndrome, moderate tricuspid regurgitation may be associated with increasing age, geometrical changes of the annulus, leaflet prolapse, lateral papillary muscle displacement, and subsequent leaflet tethering, as well as a smaller septal leaflet.

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“…[93][94][95] In the former condition, the AV node and His bundle are displaced in an anterior direction away from the usual position in Koch's triangle, whereas in the latter, the AV node and His bundle are displaced posterior to Koch's triangle. The functional properties of these displaced conduction systems are often abnormal.…”

Section: Av Block In Chdmentioning

confidence: 99%