Faculty Collaboration Database

Promising Outcome of Anatomic Correction of Corrected Transposition of the Great Arteries. Ann Thorac Surg 2017 Aug;104(2):650-656

Date

06/27/2017

Pubmed ID

28648534

DOI

10.1016/j.athoracsur.2017.04.050

Scopus ID

2-s2.0-85021159547 (requires institutional sign-in at Scopus site)   27 Citations

Abstract

BACKGROUND: Anatomic correction of corrected transposition of the great arteries with associated lesions, utilizing the morphologic left ventricle as a systemic pumping chamber, is the preferred method in many centers. The purpose of this study was to analyze functional outcome after anatomic correction.

METHODS: Between Jan 1997 and May 2016, 63 patients with corrected transposition of the great arteries and associated lesions underwent anatomic correction. Forty-two patients (67%) underwent palliation before correction, including 14 patients (22%) who required training of systemic ventricle. The double switch procedure was performed in 37 patients; 25 patients underwent the Senning-Rastelli operation, and 1 patient underwent the Senning-Nikaidoh procedure. The median age at correction was 1.6 ± 3.7(SD) years (range, 0.2 to 17.8 years).

RESULTS: The survival and freedom from any event was 95% and 71%, respectively, at 15-year follow-up. The combined freedom from death, failure of systemic ventricle, or heart transplant was 93% at 15-year follow-up regardless of procedure type. Sinus rhythm was present in 49 patients, with 14 patients requiring pacemaker (22%)-8 preoperatively, 4 early postoperatively, and 2 late postoperatively. Neurological development is normal in all patients. Fifty-four percent of the patients are not on medication.

CONCLUSIONS: Anatomic correction of corrected transposition of the great arteries is a safe procedure that provides encouraging survival and functional benefits. Ninety-three percent preservation of morphological left ventricle function in 15 years of follow-up supports the concept of anatomic correction. Longer follow-up is needed to confirm superiority of this approach over other management strategies.

Author List

Hraska V, Vergnat M, Zartner P, Hart C, Suchowerskyj P, Bierbach B, Schindler E, Schneider M, Asfour B

Author

Viktor Hraska MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Cardiac Surgical Procedures
Child
Child, Preschool
Echocardiography, Doppler
Female
Follow-Up Studies
Forecasting
Heart Ventricles
Humans
Infant
Male
Retrospective Studies
Transposition of Great Vessels
Treatment Outcome
Ventricular Function