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Anatomic Repair of Congenitally Corrected Transposition of the Great Arteries: Single-Center Intermediate-Term Experience

Pediatric Cardiology volume 38, pages 1696–1702 (2017)Cite this article

Abstract

We present our experience for patients who have undergone an anatomic repair (AR) for congenitally corrected transposition of the great arteries (CCTGA) at the Children’s Hospital of Wisconsin. A retrospective chart review of patients who underwent AR for CCTGA from 2001 to 2015 was performed. The cohort consisted of 15 patients (74% male). Median age of anatomic repair was 15 months (range 4.5–45.6 months). Four patients had a bidirectional Glenn (BDG) prior to AR. At the time of AR,—9 (60%) underwent Senning/Rastelli procedure, 4 (26.6%) had double switch operation, and 2 (13.3%) underwent only Senning with VSD closure. Median duration of follow-up was 5.5 years (0.05–14 years). Reoperations prior to discharge included BDG, revision of pulmonary venous baffle, closure of residual VSD, and pacemaker placement. Late reoperations included left ventricular outflow tract obstruction repair, conduit replacement, melody valve placement, and pacemaker implantation. At their most recent follow-up, no patient had heart failure symptoms and only 1 had severely diminished function that improved with cardiac resynchronization therapy. Moderate mitral regurgitation was noted in 15% (2/13), and severe in 7% (1/13). Moderate tricuspid regurgitation was noted in 15% (2/13). One patient, 7% (1/13), developed moderate aortic insufficiency. There was a 100% survival at the time of the most recent follow-up. Patients with CCTGA who have undergone AR have excellent functional status and mid-term survival but reinterventions are common. Longer term studies are needed to determine both the extent and spectrum of reinterventions as well as long term survival.

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Fig. 1

Abbreviations

AR:

Anatomic repair

BDG:

Bidirectional glenn

CCTGA:

Congenitally corrected transposition of the great arteries

MBTS:

Modified Blalock–Taussig shunt

PA:

Pulmonary artery

VSD:

Ventricular septal defect

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Affiliations

  1. Children’s Hospital of Wisconsin, Milwaukee, WI, USA

    Shagun Sachdeva, Roni M. Jacobsen, Ronald K. Woods, Michael E. Mitchell, Joseph R. Cava, Nancy S. Ghanayem, Peter C. Frommelt & Peter J. Bartz

  2. Cincinnati Children’s Hospital Medical Center, University of Cincinnati, 3333 Burnet Ave, Cincinnati, OH, 45229, USA

    James S. Tweddell

Authors
  1. Shagun Sachdeva
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  2. Roni M. Jacobsen
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  3. Ronald K. Woods
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  4. Michael E. Mitchell
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  5. Joseph R. Cava
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  6. Nancy S. Ghanayem
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  7. Peter C. Frommelt
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  8. Peter J. Bartz
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  9. James S. Tweddell
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Correspondence to James S. Tweddell.

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Meeting Presentation: 2017 American College of Cardiology, Washington DC.

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Sachdeva, S., Jacobsen, R.M., Woods, R.K. et al. Anatomic Repair of Congenitally Corrected Transposition of the Great Arteries: Single-Center Intermediate-Term Experience. Pediatr Cardiol 38, 1696–1702 (2017). https://doi.org/10.1007/s00246-017-1715-5

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  • DOI: https://doi.org/10.1007/s00246-017-1715-5

Keywords

  • Transposition
  • Anatomic repair
  • Outcomes