Morphology, Surgical Techniques, and Outcomes in Patients Above 15 Years Undergoing Surgery for Congenitally Corrected Transposition of Great Arteries

Abstract

Older patients with ccTGA present a challenge. Fontan/BD Glenn remains a good option for patients who presented with VSD PS. Both anatomic and physiological BV repairs provide acceptable results. Tricuspid valve replacement is safe for patients presenting with TR who have improvement in functional class, though the right ventricular function may not improve.

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

“…As a rule, a similar strategy should also be adopted when tricuspid valve treatment is required in patients with ccTGA. However, the tricuspid valve often has morphological abnormalities, occasionally assuming an Ebstein-like form [1,7]. Subsequent to our experience about the switch to valve replacement (Case 1 from Group C), valve replacement has been applied as a basic procedure at our center.…”

“…If the form of the tricuspid valve in patients with ccTGA is considered, tricuspid valve replacement (TVR) with a mechanical valve appears to be a realistic choice as a method for treating severe tricuspid regurgitation [7,8,9], although there has been a report of valvuloplasty for this purpose [10]. However, considering the size of the valve to be implanted and subsequent need for anticoagulant therapy, determining the timing of TVR is a challenging issue for cardiac physicians.…”

Long‐Term Outcomes of Tricuspid Valve Surgery in Patients With Congenitally Corrected Transposition of the Great Arteries

“…According to previous studies regarding TV surgery in CCTGA patients,12, 18, 19, 20 TVP was considered inferior to TVR, because of the discouraging late results and a high rate of recurrent TR. Some institutions preferred valve replacement in almost all cases 16.…”

“…To date, very few studies have been reported examining the long‐term outcomes of TV surgery in patients with CCTGA, and it is still controversial among cardiac surgeons. Among the limited studies, valvuloplasty was not recommended because of unsatisfactory outcomes . The aims of the present study are to compare the long‐term results between valvuloplasty and valve replacement in patients with CCTGA, and to identify the risk factors for postoperative mortality in these patients.…”

Outcomes and Prognostic Factors for Adult Patients With Congenital Heart Disease Undergoing Primary or Reoperative Systemic Atrioventricular Valve Surgery

“…Previous study of valvular surgery in ACHD is limited, largely consisting of case series. For instance, two prior studies have examined adults with congenital mitral valve disease undergoing surgery, 2,3 and while several studies have examined patients with ccTGA requiring surgical intervention, [4][5][6][7][8][9] only two of these studies have analyzed risk factors for adverse outcomes. 6,9 The AVSD studies largely concentrate on the pediatric population undergoing primary repair.…”