Evaluation of Prognostic Factors in Corrected Transposition of the Great Arteries at Mid-term Follow-up.
- Author:
Young Hwan SONG
1
;
Hyok Joo KWON
;
Gi Beom KIM
;
Soo Jung KANG
;
Eun Jung BAE
;
Chung Il NOH
;
Yong Soo YUN
;
Jeong Ryul LEE
;
Yong Jin KIM
;
Joon Ryang RHO
Author Information
1. Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea. chungnoh@plaza.snu.ac.kr
- Publication Type:Original Article
- Keywords:
Corrected transposition of the great vessels;
Tricuspid valve insufficiency
- MeSH:
Arteries*;
Atrioventricular Block;
Ebstein Anomaly;
Female;
Follow-Up Studies*;
Heart Septal Defects, Ventricular;
Humans;
Medical Records;
Mental Competency;
Prognosis;
Pulmonary Valve Stenosis;
Retrospective Studies;
Seoul;
Survival Rate;
Tricuspid Valve;
Tricuspid Valve Insufficiency;
Ventricular Function, Right
- From:Journal of the Korean Pediatric Society
2003;46(2):154-161
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The prognosis of patients with corrected transposition of the great arteries(C-TGA) is variably affected by associated intracardiac defects, systemic right ventricular function, tricuspid valve competence, and conduction disturbances. This study aims to evaluate the importance of those factors at mid-term follow-up. METHODS: Medical records of 94 patients(males 58, females 36; mean age at last follow-up, 12+/-9 years; mean follow-up duration, 9+/-6.4 years) diagnosed between January 1980 and May 2002 at Seoul National University Children's Hospital were studied retrospectively. RESULTS: Among 94 patients, operations were performed in 72 patients(classic operations in 55; double switch operations in 17). Among prognostic factors including associated intracardiac anomalies(at least moderately severe tricuspid insufficiency(TI), ventricular septal defect, pulmonary stenosis and pulmonary atresia), intracardiac operation and complete atrioventricular block, TI was the only significant factor for death(P=0.001), and in turn, Ebstein anomaly and high grade atrioventricular block predicted TI. 20-year survival without TI was 77%, but only 35% with TI(P=0.0002); excluding perioperative death, the 20-year survival rates with and without TI were 48% and 87% respectively(P= 0.008). There was no statistical difference in 20-year survival rate or association with TI between classic and double switch operation. CONCLUSION: TI was the major prognostic factor for C-TGA and was associated with Ebstein anomaly and high grade atrioventricular block at mid-term follow-up. Long-term follow-up is required to evaluate other factors, including double switch operations and associated intracardiac defects more exactly.
