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.
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: J A van Son; G K Danielson; J C Huhta; C A Warnes; W D Edwards; H V Schaff; F J Puga; D M Ilstrup Journal: J Thorac Cardiovasc Surg Date: 1995-04 Impact factor: 5.209
Authors: Sarah E Bowater; Tara J Selman; Lucy E Hudsmith; Paul F Clift; Peter J Thompson; Sara A Thorne Journal: Congenit Heart Dis Date: 2012-09-12 Impact factor: 2.007
Authors: Shagun Sachdeva; Roni M Jacobsen; Ronald K Woods; Michael E Mitchell; Joseph R Cava; Nancy S Ghanayem; Peter C Frommelt; Peter J Bartz; James S Tweddell Journal: Pediatr Cardiol Date: 2017-09-16 Impact factor: 1.655