Document Detail


Outcomes of biventricular repair for congenitally corrected transposition of the great arteries.
MedLine Citation:
PMID:  20103227     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: This study was undertaken to evaluate long-term results of biventricular repairs for congenitally corrected transposition of the great arteries, and to analyze the risk factors that affect mortality and morbidity. METHODS: Between 1983 and 2009, 167 patients with congenitally corrected transposition of the great arteries underwent biventricular repairs. The physiologic repairs were performed in 123 patients, and anatomic repairs in 44. Average follow-up was 9.3 +/- 6.6 years. RESULTS: Kaplan-Meier estimated survival was 83.3% +/- 0.5% at 25 years in biventricular repair. In anatomic repair, left ventricular training and right ventricular dysfunction had negative impact on survival, but bidirectional cavopulmonary shunt had positive impact on survival. The reoperation-free ratio was 10.1% +/- 7.8% at 22 years after physiologic repair, and 46.2% +/- 12.4% at 15 years after anatomic repair (p = 0.885). Freedom from any arrhythmia was 49.6% +/- 7.5% at 22 years after physiologic repair, and 60.8% +/- 14.8% at 18 years after anatomic repair (p = 0.458). Freedom from systemic atrioventricular valve and ventricular dysfunction as well as tricuspid valve and right ventricular dysfunction was significantly higher in anatomic repair than in physiologic repair. CONCLUSIONS: Long-term results of biventricular repair were satisfactory. Patients presenting with right ventricular dysfunction or need for left ventricular training represent a high-risk group of anatomic repair for which selection criteria are particularly important. Late functional outcomes of anatomic repair were excellent compared with physiologic repair. Anatomic repair is the procedure of choice for those patients if both ventricles are adequate or if surgical technique is modified with the help of additional a bidirectional cavopulmonary shunt.
Authors:
Hong-Gook Lim; Jeong Ryul Lee; Yong Jin Kim; Young-Hwan Park; Tae-Gook Jun; Woong-Han Kim; Chang-Ha Lee; Han Ki Park; Ji-Hyuk Yang; Chun-Soo Park; Jae Gun Kwak
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  89     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-27     Completed Date:  2010-03-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  159-67     Citation Subset:  AIM; IM    
Copyright Information:
2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul National University Children's Hospital, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Cardiac Surgical Procedures / methods*
Child
Child, Preschool
Echocardiography
Follow-Up Studies
Heart Ventricles / physiopathology,  surgery*,  ultrasonography
Humans
Infant
Infant, Newborn
Korea / epidemiology
Middle Aged
Retrospective Studies
Survival Rate / trends
Time Factors
Transposition of Great Vessels / mortality,  physiopathology,  surgery*
Treatment Outcome
Ventricular Function / physiology*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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