Long-Term Outcomes of Definitive Surgical Repair for Congenitally Corrected Transposition of the Great Arteries

Yuki Nakamoto, Tomomi Nishimura, Kanako Kishiki, Akio Inage, Tomomi Ueda, Tadahiro Yoshikawa, In-Sam Park, Yasuo Murakami, Naoki Wada, Makoto Ando, Yukihiro Takahashi
2014 Pediatric Cardiology and Cardiac Surgery  
Keywords: congenitally corrected transposition of the great arteries, Rastelli procedure, double switch operation, Fontan operation Objective: To determine optimal treatment strategies by examining the long-term outcomes and challenges of different surgical procedures for congenitally corrected transposition of the great arteries (ccTGA) . Subjects: Clinical records of 71 patients with ccTGA, who underwent definitive surgery (physiologic: 45; anatomic: 14; and Fontan-type: 12) in our hospital
more » ... om November 1977 to October 2013, were retrospectively reviewed. Results: During the follow-up period, there were 7 deaths in 71 patients. Late mortality occurred in 6 patients (in 5 of which TVR was performed) after physiologic repair and early mortality occurred in 1 patient after anatomic repair. While there were no significant differences in the postoperative survival and reoperation rates between the groups, those who underwent physiologic repair with TVR showed a low postoperative survival rate (20-year survival rate with and without TVR: 58.6 and 96.3%, respectively) . After anatomic repair, those treated with Jatene-type DS showed the most favorable prognosis, not requiring reoperation or PMI. In contrast, those treated with Rastelli-type DS frequently needed reoperation and PMI. All Fontan group patients survived, although complications (PLE and hepatic tumor) occurred during the long-term follow-up period. Conclusion: When treating ccTGA, it may be important to develop treatment strategies, according to individual pathological conditions, and stratifying risks.
doi:10.9794/jspccs.30.465 fatcat:6vbxibkkdzgx5lt26gvttx3y5u