Pediatric Cardiology and Cardiac Surgery
Online ISSN : 2187-2988
Print ISSN : 0911-1794
ISSN-L : 0911-1794
Originals
Long-Term Outcomes of Definitive Surgical Repair for Congenitally Corrected Transposition of the Great Arteries
Yuki NakamotoTomomi NishimuraKanako KishikiAkio InageTomomi UedaTadahiro YoshikawaIn-Sam ParkYasuo MurakamiNaoki WadaMakoto AndoYukihiro Takahashi
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2014 Volume 30 Issue 4 Pages 465-473

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Abstract
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 from 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.
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© 2013 Japanese Society of Pediatric Cardiology and Cardiac Surgery
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