Anatomic correction for congenitally corrected transposition of the great arteries and 10-year follow-up: A retrospective cohort study
- VernacularTitle:先天性矫正型大动脉转位解剖纠治的外科策略及十年随访的回顾性队列研究
- Author:
HE Xiaomin
1
;
ZHENG Jinghao
1
;
LUO Kai
1
;
SUN Qi
1
;
ZHU Zhongqun
1
;
XU Zhiwei
1
;
LIU Jinfen
1
Author Information
1. Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, 200127, P.R.China
- Publication Type:Journal Article
- Keywords:
Congenitally corrected transposition of the great arteries;
anatomic correction;
double switch;
one and a half ventricular repair
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2020;27(03):255-259
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effects of anatomic correction for congenitally corrected transposition of the great arteries (ccTGA) and 10-year follow-up. Methods From January 2008 to December 2018, 48 patients with ccTGA who underwent anatomic correction were reviewed. There were 29 males and 19 females with age of 39.2 (3-91) months. The cohort was divided into two groups: a biventricular anatomic correction group (39 patients) and a 1.5 ventricular anatomic correction group (9 patients). They were followed for in-hospital mortality, late mortality, long-term survival, freedom from reoperation, and heart function. Results There were 3 early deaths and 2 early re-intervention in the biventricular anatomic correction group, but no death and only one re-intervention in the 1.5 ventricular anatomic correction group. Compared with the biventricular anatomic correction group, the operation time, tracheal intubation and ICU time were significantly reduced or shortened in the 1.5 ventricular anatomic correction group (P<0.05). The patients were followed up for 0.5-10.4 years. Four patients were lost. Two patients died in the biventricular anatomic correction group, and two patients received re-intervention. The 1-year, 5-year and 10-year survival rate was 88.2%, 84.0%, and 84.0%, respectively. There was no death or intervention in the 1.5 ventricular anatomic correction group. The quality of life of the other patients in the medium-term follow-up was satisfactory. Only 2 patients were classified as grade Ⅲ in cardiac function, and the other patients were classified as grade Ⅰ-Ⅱ. Conclusion According to the different anatomic characteristics of ccTGA, the individualized strategy of anatomic correction can achieve satisfactory surgical results, and the medium-term quality of life was good. Especially, 1.5 ventricular anatomic correction may obtain better therapeutic effects because of its lower operative mortality and less postoperative complications.
