Document Detail

Long-term outcome in congenitally corrected transposition of the great arteries: a multi-institutional study.
MedLine Citation:
PMID:  10898443     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The purpose of this study was to determine long-term outcome in adults with congenitally corrected transposition of the great arteries (CCTGA), with particular emphasis on systemic ventricular dysfunction and congestive heart failure (CHF). BACKGROUND: Patients with CCTGA have the anatomical right ventricle as their systemic pumping chamber, with ventricular dysfunction and CHF being relatively common in older adults. METHODS: Retrospective analysis of records of 182 patients from 19 institutions were reviewed to determine current status and possible risk factors for systemic ventricular dysfunction and CHF. Factors considered included age, gender, associated cardiac defects, operative history, heart block, arrhythmias and tricuspid (i.e., systemic atrioventricular) regurgitation (TR). RESULTS: Both CHF and systemic ventricular dysfunction were common in groups with or without associated cardiac lesions. By age 45, 67% of patients with associated lesions had CHF, and 25% of patients without associated lesions had this complication. The rates of systemic ventricular dysfunction and CHF were higher with increasing age, the presence of significant associated cardiac lesions, history of arrhythmia, pacemaker implantation, prior surgery of any type, and particularly with tricuspid valvuloplasty or replacement. Aortic regurgitation (a previously unreported problem) was also relatively common in this patient population. CONCLUSIONS: Patients with CCTGA are increasingly subject to CHF with advancing age; this complication is extremely common by the fourth and fifth decades. Tricuspid (systemic atrioventricular) valvular regurgitation is strongly associated with RV (anatomical right ventricle connected to aorta in CCTGA patients; systemic ventricle in CCTGA) dysfunction and CHF; whether it is causative or a secondary complication remains speculative.
T P Graham; Y D Bernard; B G Mellen; D Celermajer; H Baumgartner; F Cetta; H M Connolly; W R Davidson; M Dellborg; E Foster; W M Gersony; I H Gessner; R A Hurwitz; H Kaemmerer; J D Kugler; D J Murphy; J A Noonan; C Morris; J K Perloff; S P Sanders; J L Sutherland
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  36     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2000 Jul 
Date Detail:
Created Date:  2000-08-01     Completed Date:  2000-08-01     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  255-61     Citation Subset:  AIM; IM    
Vanderbilt University Medical Center, Nashville, Tennessee 37232-2572, USA.
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MeSH Terms
Age Factors
Echocardiography, Doppler
Follow-Up Studies
Heart Failure / epidemiology,  etiology*,  physiopathology
Retrospective Studies
Risk Factors
Sex Factors
Transposition of Great Vessels / complications*,  physiopathology,  ultrasonography
Ventricular Dysfunction / epidemiology,  etiology*,  physiopathology

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