Abstract
It has been controversial how to manage severe dysfunction of the systemic right ventricle and severe tricuspid regurgitation for adult patients with congenitally corrected transposition of the great arteries. We reported a 43-year-old man with these disorders, who received pulmonary artery banding and cardiac resynchronization therapy without cardiopulmonary bypass. The degree of the tricuspid regurgitation was improved to mild–moderate and systemic right ventricular ejection fraction was improved from 28 to 45% after surgery. Cardiopulmonary exercise testing showed that the predictive value of anaerobic threshold and peak oxygen uptake improved from 65 to 99% and 59 to 92%, respectively. In conclusion, pulmonary artery banding and cardiac resynchronization therapy can be the first choice of surgery for severe tricuspid regurgitation with severely impaired systemic right ventricular function. After improving systemic right ventricular dysfunction tricuspid surgery could be the next choice as a surgical intervention in the future.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Dobson R, Danton M, Nicola W, Hamish W. The natural and unnatural history of the systemic right ventricle in adult survivors. J Thorac Cardiovasc Surg. 2013;145(6):1493–501 discussion 501-3.
Koolbergen DR, Ahmed Y, Bouma BJ, Scherptong RW, Bruggemans EF, Vliegen HW, et al. Follow-up after tricuspid valve surgery in adult patients with systemic right ventricles. Eur J Cardiothorac Surg. 2016;50(3):456–63.
Kral Kollars CA, Gelehrter S, Bove EL, Ensing G. Effects of morphologic left ventricular pressure on right ventricular geometry and tricuspid valve regurgitation in patients with congenitally corrected transposition of the great arteries. Am J Cardiol. 2010;105(5):735–9.
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):1293–302.
Helsen F, De Meester P, Van Keer J, Gabriels C, Van De Bruaene A, Herijgers P, et al. Pulmonary outflow obstruction protects against heart failure in adults with congenitally corrected transposition of the great arteries. Int J Cardiol. 2015;196:1–6.
Hraska V, Duncan BW, Mayer JE Jr, Freed M, del Nido PJ, Jonas RA. Long-term outcome of surgically treated patients with corrected transposition of the great arteries. J Thorac Cardiovasc Surg. 2005;129(1):182–91.
Janousek J, Gebauer RA, Abdul-Khaliq H, Turner M, Kornyei L, Grollmuss O, et al. Cardiac resynchronisation therapy in paediatric and congenital heart disease: differential effects in various anatomical and functional substrates. Heart (Br Card Soc). 2009;95(14):1165–71.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
Authors have nothing to disclose with regard to commercial support.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Kadowaki, S., Kotani, Y., Toh, N. et al. The impact of pulmonary artery banding and cardiac resynchronization therapy for the adult patient with congenitally corrected transposition of the great arteries. Gen Thorac Cardiovasc Surg 68, 1024–1026 (2020). https://doi.org/10.1007/s11748-019-01171-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11748-019-01171-x