Anatomic repair for congenitally corrected transposition of the great arteries

Sharma, Rajesh; Talwar, Sachin; Marwah, Ashutosh; Shah, Sejal; Maheshwari, Sunita; Suresh, Pujari; Garg, Rajnish; Bali, Bijender Singh; Juneja, Rajnish; Saxena, Anitá; Kothari, Shyam Sunder

doi:10.1016/j.jtcvs.2008.09.048

Cited by 49 publications

(46 citation statements)

References 22 publications

(45 reference statements)

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“…In patients who require complex biventricular repair or not candidates for biventricular repair, it has been reported that Fontan operation had more successful results (18,24) . Another treatment option for this type of patients is one-and-one half ventricle repair between Fontan circulation and classic conventional physiological surgical repair (25) .…”

Section: Dıscussıonmentioning

confidence: 99%

Midterm evaluation of echocardiographic examination, cardiac catheterization findings and surgical results of patients with congenitally corrected transposition of great arteries: A single center experience

Bulut¹,

Yücel²,

Ballı³

et al. 2017

BUCH

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Congenitally corrected transposition of the great arteries (cc-TGA), is also defined as double discordance and ventricular inversion. We conducted a retrospective evaluation of medical records of 79 patients diagnosed and followed-up with congenital transposition of great arteries between December 1993 and January 2014 at our pediatric cardiology department. Of 79 patients included in the study, 46 (58.2%) were male, mean age at diagnosis was 40±39.25 months and the mean follow-up time was 56±39.4 months. Thirteen (16.5%) patients had atrial situs inversus. The most common concomitant abnormality was found to be ventricular septal defet (29.1%). Fourty-five patients had pulmonary stenosis either in the form of valvular, subvalvular or both together. Twelve (15.2%) patients had pulmonary atresia. Systemic atrioventricular valve (AV) regurgitation was present in 51 (64.6%) patients, whereas 2 (2.5%) patients had severe systemic AV valve regurgitation. Ebstein-like AV valve was detected in 5 (6.3%) patients. Transcatheter interventions included ductal stent implantation (n=5; 6.3%), left ventriculopulmonary artery conduit angioplasty (n=2; 2.5%), RV-PA conduit angioplasty (n=1; 1.3%) and pulmonary balloon valvuloplasty (n=2; 2.5%). Eleven (13.9%) patients underwent interventional therapeutic cardiac catheterization. Glenn anastomosis was performed in 16 (20.3%) patients. Nine (11.4%) patients required a permanent pacemaker implantation. Individualization of treatments and managements for the patients is of prognostic importance for these patients needing lifelong follow-up due to the large number of accompanying anomalies and different degrees of abnormalities in cc-TGA patients.

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Section: Dıscussıonmentioning

confidence: 99%

Midterm evaluation of echocardiographic examination, cardiac catheterization findings and surgical results of patients with congenitally corrected transposition of great arteries: A single center experience

Bulut¹,

Yücel²,

Ballı³

et al. 2017

BUCH

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“…20,21 The heart is displaced into the left pleural cavity for adequate atrial exposure and venous cannulation should be direct and extrapericardial. Pericardial/prosthetic patch is used to augment the first and second layers.…”

Section: Atrial Switch Operation In Cctgasmentioning

confidence: 99%

Atrial Switch Operation in the Current Era

Talwar

Nair

Choudhary

et al. 2012

World J Pediatr Congenit Heart Surg

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Although rarely performed today, atrial switch operations continue to have an important role in the management of some forms of congenital heart disease. In developing countries, delayed diagnosis and presentation of patients with transposition of the great arteries is not uncommon. For some patients who are referred for surgery beyond the newborn period, the atrial switch operations are still considered to be the best option. Also, as part of surgical repair of congenitally corrected transposition, an atrial switch operation is combined with arterial switch or the Rastelli procedure as an alternative to physiologic repair. In isolated ventricular inversion (atrioventricular discordance with ventriculoarterial concordance), the atrial switch operation alone leads to complete anatomical correction. Finally, management of late complications of atrial switch operations requires a thorough understanding of the procedures.

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“…Sharma et al (23) reported on double switch operation or congenitally corrected TGA in 68 patients. Group 1 comprised 31 patients at a mean age of 94 months who underwent a combined Rastelli and atrial switch operation.…”

Section: Tgamentioning

confidence: 99%

The Year in Congenital Heart Disease

Graham

2010

Journal of the American College of Cardiology

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With the increasing number of excellent papers related to congenital heart disease, it has become more difficult to select those that are perceived to be particularly critical to scientific developments in the field. I have chosen in this review to focus almost entirely on results and to follow surgical-or catheterbased interventions that highlight the complex conditions that surgeons and cardiologists now are able to repair or palliate successfully. Sections chosen are tetralogy of Fallot (TOF), Fontan operation, cardiac surgery in general, transposition of the great arteries (TGA), hypoplastic left heart syndrome (HLHS), aortic valve surgery, aortoplasty, and ventricular septal defect (VSD) management. These particular areas were chosen because of the importance to the general field of congenital heart disease, and many of the areas highlighted continue to plague investigators as they attempt to improve long-term outcomes. TOFPapers about TOF include issues related to initial intervention assessment of pulmonary regurgitation (PR) timing of pulmonary valve replacement (PVR) as well as late follow-up and implication for management.Tamesberger et al.(1) reported 90 consecutive infants who underwent early repair: 25 neonates repaired due to duct-dependent pulmonary circulation or severe hypoxemia and 65 infants Ͻ4 months old with elective repair. Their results indicated no 30-day mortality, and late mortality of 2% with median follow-up of 4.7 years. Seven of 88 (8%) needed reoperation and 12 of 88 required reintervention. The younger patients did not differ significantly in intensive care unit stay, ventilator days, hospital stay, complications, or reoperation. There were more frequent transannular patches and reinterventions in the younger infants. These are excellent results, but will such early repair result in more severe PR and the need for more frequent PVR? Dohlen et al.(2) reported right ventricular outflow tract (VOT) stenting in 9 infants because of cyanosis or ductdependency and adverse risk factors. Stenting improved O 2 saturation from 73% to 94%. Median left pulmonary artery (PA) z-score increased from Ϫ4.9 to Ϫ1.5, right PA increased from Ϫ3.7 to Ϫ0.8, and Nakata index increased from 56 to 150 mm 2 /m 2 . There were no procedural complications. Six patients have undergone repair with no deaths. This is another method to palliate infants who are duct-dependent with adverse risk factors and have a pulmonary valve that is deemed unsalvageable. Stenting allows infants to obtain a greater age and size when repair theoretically is safer.Papadopoulos et al. (3) reported repair of pulmonary valves in 5 children and 2 adults. All had severe PR associated with right ventricular (RV) dilation and dysfunction after primary right VOT reconstruction. There were no operative or late deaths. All valves were repaired successfully with a mean PR grade of 1.3 post-operatively. Mean transvalvular gradient was 20 mm Hg for children and 23 mm Hg for adults. The mean RV dilation index decreased significantly from 0.85 to...

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Anatomic repair for congenitally corrected transposition of the great arteries

Abstract: The occurrence of left ventricular dysfunction indicate that anatomic repair in the arterial switch group is still fraught with imperfections. The Rastelli group required conduit revisions but has otherwise performed well.

Cited by 49 publications

References 22 publications

Midterm evaluation of echocardiographic examination, cardiac catheterization findings and surgical results of patients with congenitally corrected transposition of great arteries: A single center experience

Midterm evaluation of echocardiographic examination, cardiac catheterization findings and surgical results of patients with congenitally corrected transposition of great arteries: A single center experience

Atrial Switch Operation in the Current Era

The Year in Congenital Heart Disease

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