Anatomic correction for congenitally corrected transposition of the great arteries and 10-year follow-up: A retrospective cohort study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

HE Xiaomin ,  ZHENG Jinghao , LUO Kai , SUN Qi , ZHU Zhongqun , XU Zhiwei , LIU Jinfen

Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, 200127, P.R.China;

Corresponding author：

ZHENG Jinghao, Email: zhengjh210@163.com

Keywords：

Congenitally corrected transposition of the great arteries; anatomic correction; double switch; one and a half ventricular repair

DOI：

10.7507/1007-4848.202001018

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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.

Citation： HE Xiaomin, ZHENG Jinghao, LUO Kai, SUN Qi, ZHU Zhongqun, XU Zhiwei, LIU Jinfen. Anatomic correction for congenitally corrected transposition of the great arteries and 10-year follow-up: A retrospective cohort study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(3): 255-259. doi: 10.7507/1007-4848.202001018 Copy

1.	Filippov AA, Del Nido PJ, Vasilyev NV. Management of systemic right ventricular failure in patients with congenitally corrected transposition of the great arteries. Circulation, 2016, 134(17): 1293-1302.
2.	Bogers AJ, Head SJ, de Jong PL, et al. Long term follow up after surgery in congenitally corrected transposition of the great arteries with a right ventricle in the systemic circulation. J Cardiothorac Surg, 2010, 5: 74.
3.	郑景浩, 祝忠群, 孙琦, 等. 小儿ccTGA解剖纠治术中应用双向Glenn/半Mustard心房调转双调转手术的初步研究. 中华胸心血管外科杂志, 2017, 33(12): 705-707.
4.	Wallis GA, Debich-Spicer D, Anderson RH. Congenitally corrected transposition. Orphanet J Rare Dis, 2011, 6: 22.
5.	Adachi O, Masaki N, Kawatsu S, et al. Long-term results after physiologic repair for congenitally corrected transposition of the great arteries. Gen Thorac Cardiovasc Surg, 2016, 64(12): 715-721.
6.	Sachdeva S, Jacobsen RM, Woods RK, et al. Anatomic repair of congenitally corrected transposition of the great arteries: single-center intermediate-term experience. Pediatr Cardiol, 2017, 38(8): 1696-1702.
7.	Kutty S, Danford DA, Diller GP, et al. Contemporary management and outcomes in congenitally corrected transposition of the great arteries. Heart, 2018, 104(14): 1148-1155.
8.	Lenoir M, Bouhout I, Gaudin R, et al. Outcomes of the anatomical repair in patients with congenitally corrected transposition of the great arteries: lessons learned in a high-volume centre. Eur J Cardiothorac Surg, 2018, 54(3): 532-538.
9.	Myers PO, del Nido PJ, Geva T, et al. Impact of age and duration of banding on left ventricular preparation before anatomic repair for congenitally corrected transposition of the great arteries. Ann Thorac Surg, 2013, 96(2): 603-610.
10.	Metton O, Gaudin R, Ou P, et al. Early prophylactic pulmonary artery banding in isolated congenitally corrected transposition of the great arteries. Eur J Cardiothorac Surg, 2010, 38(6): 728-734.
11.	Helbing WA, Hansen B, Ottenkamp J, et al. Long-term results of atrial correction for transposition of the great arteries. Comparison of Mustard and Senning operations. J Thorac Cardiovasc Surg, 1994, 108(2): 363-372.
12.	Karl TR, Weintraub RG, Brizard CP, et al. Senning plus arterial switch operation for discordant (congenitally corrected) transposition. Ann Thorac Surg, 1997, 64(2): 495-502.
13.	Brizard CP, Lee A, Zannino D, et al. Long-term results of anatomic correction for congenitally corrected transposition of the great arteries: A 19-year experience. J Thorac Cardiovasc Surg, 2017, 154(1): 256-265.
14.	Talwar S, Bansal A, Choudhary SK, et al. Results of Fontan operation in patients with congenitally corrected transposition of great arteries. Interact Cardiovasc Thorac Surg, 2016, 22(2): 188-193.
15.	DiBardino DJ, Heinle JS, Fraser CD Jr. The hemi-Mustard, bi-directional Glenn, and Rastelli operations used for correction of congenitally corrected transposition, achieving a "ventricle and a half " repair. Cardiol Young, 2004, 14(3): 330-332.
16.	Malhotra SP, Reddy VM, Qiu M, et al. The hemi-Mustard/bidirectional Glenn atrial switch procedure in the double-switch operation for congenitally corrected transposition of the great arteries: rationale and midterm results. J Thorac Cardiovasc Surg, 2011, 141(1): 162-170.

1. Filippov AA, Del Nido PJ, Vasilyev NV. Management of systemic right ventricular failure in patients with congenitally corrected transposition of the great arteries. Circulation, 2016, 134(17): 1293-1302.
2. Bogers AJ, Head SJ, de Jong PL, et al. Long term follow up after surgery in congenitally corrected transposition of the great arteries with a right ventricle in the systemic circulation. J Cardiothorac Surg, 2010, 5: 74.
3. 郑景浩, 祝忠群, 孙琦, 等. 小儿ccTGA解剖纠治术中应用双向Glenn/半Mustard心房调转双调转手术的初步研究. 中华胸心血管外科杂志, 2017, 33(12): 705-707.
4. Wallis GA, Debich-Spicer D, Anderson RH. Congenitally corrected transposition. Orphanet J Rare Dis, 2011, 6: 22.
5. Adachi O, Masaki N, Kawatsu S, et al. Long-term results after physiologic repair for congenitally corrected transposition of the great arteries. Gen Thorac Cardiovasc Surg, 2016, 64(12): 715-721.
6. Sachdeva S, Jacobsen RM, Woods RK, et al. Anatomic repair of congenitally corrected transposition of the great arteries: single-center intermediate-term experience. Pediatr Cardiol, 2017, 38(8): 1696-1702.
7. Kutty S, Danford DA, Diller GP, et al. Contemporary management and outcomes in congenitally corrected transposition of the great arteries. Heart, 2018, 104(14): 1148-1155.
8. Lenoir M, Bouhout I, Gaudin R, et al. Outcomes of the anatomical repair in patients with congenitally corrected transposition of the great arteries: lessons learned in a high-volume centre. Eur J Cardiothorac Surg, 2018, 54(3): 532-538.
9. Myers PO, del Nido PJ, Geva T, et al. Impact of age and duration of banding on left ventricular preparation before anatomic repair for congenitally corrected transposition of the great arteries. Ann Thorac Surg, 2013, 96(2): 603-610.
10. Metton O, Gaudin R, Ou P, et al. Early prophylactic pulmonary artery banding in isolated congenitally corrected transposition of the great arteries. Eur J Cardiothorac Surg, 2010, 38(6): 728-734.
11. Helbing WA, Hansen B, Ottenkamp J, et al. Long-term results of atrial correction for transposition of the great arteries. Comparison of Mustard and Senning operations. J Thorac Cardiovasc Surg, 1994, 108(2): 363-372.
12. Karl TR, Weintraub RG, Brizard CP, et al. Senning plus arterial switch operation for discordant (congenitally corrected) transposition. Ann Thorac Surg, 1997, 64(2): 495-502.
13. Brizard CP, Lee A, Zannino D, et al. Long-term results of anatomic correction for congenitally corrected transposition of the great arteries: A 19-year experience. J Thorac Cardiovasc Surg, 2017, 154(1): 256-265.
14. Talwar S, Bansal A, Choudhary SK, et al. Results of Fontan operation in patients with congenitally corrected transposition of great arteries. Interact Cardiovasc Thorac Surg, 2016, 22(2): 188-193.
15. DiBardino DJ, Heinle JS, Fraser CD Jr. The hemi-Mustard, bi-directional Glenn, and Rastelli operations used for correction of congenitally corrected transposition, achieving a "ventricle and a half " repair. Cardiol Young, 2004, 14(3): 330-332.
16. Malhotra SP, Reddy VM, Qiu M, et al. The hemi-Mustard/bidirectional Glenn atrial switch procedure in the double-switch operation for congenitally corrected transposition of the great arteries: rationale and midterm results. J Thorac Cardiovasc Surg, 2011, 141(1): 162-170.

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Anatomic correction for congenitally corrected transposition of the great arteries and 10-year follow-up: A retrospective cohort study

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