The long-term outcomes of physiologic repair for ccTGA (congenitally corrected transposition of the great arteries).

Abstract

PURPOSE:

The short-term outcome of physiologic repair for congenitally corrected transposition of the great arteries (ccTGA) is generally considered favorable; however, the long-term outcome is the greatest problem, especially with regard to right ventricular (RV) function and tricuspid regurgitation (TR). Although tricuspid valve replacement (TVR) appears to be a realistic choice for treating severe TR, determining the timing of TVR may be difficult.

METHODS:

We carried out a retrospective analysis of the long-term outcomes of physiologic repair for ccTGA focusing on patients with TVR. The study involved 23 patients after physiologic repair 10 or more years prior. There were 9 TVR cases in 5 pediatric patients (before age 18) and 4 adult patients.

RESULTS:

There were two late deaths; however, there was no case related with cardiac events. Overall survival at 10 and 20 years were 95.5 and 90.2 %, respectively, and 7 of 8 patients after TVR were NYHA class I or II. No patient has presented postoperative complications in the form of bleeding or embolism after TVR with mechanical valve.

CONCLUSIONS:

An analysis of the results of physiologic repair for ccTGA showed that the long-term outcome was overall favorable. To maintain RV function, early TVR may be a reasonable option, even in the management of patients during childhood.

• Authors: Keiichi Hirose, Takeshi Nishina, Naoki Kanemitsu, Akihiro Mizuno, Daisuke Yasumizu, Masashi Yada, Yohei Onga, Kazuo Yamanaka
• Journal: General thoracic and cardiovascular surgery (Gen Thorac Cardiovasc Surg) Vol. 63 Issue 9 Pg. 496-501 (Sep 2015) ISSN: 1863-6713 [Electronic] Japan
• PMID: 25964161 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Cardiac Surgical Procedures (adverse effects)
• Child
• Child, Preschool
• Congenitally Corrected Transposition of the Great Arteries
• Female
• Humans
• Male
• Postoperative Complications (physiopathology, surgery)
• Reoperation
• Retrospective Studies
• Transposition of Great Vessels (physiopathology, surgery)
• Treatment Outcome
• Tricuspid Valve Insufficiency (physiopathology, surgery)
• Ventricular Function, Right (physiology)
• Wound Healing (physiology)