Long-term surgical results of transposition of the great arteries with left ventricular outflow tract obstruction. 2022

Akihisa Furuta, and Masaaki Yamagishi, and Goki Matsumura, and Takeshi Shinkawa, and Hiroshi Niinami
Department of Cardiovascular Surgery, The Heart Institute of Japan, Tokyo Women's Medical University, 8-1, Kawadacho, Shinjuku-ku, Tokyo, 162-8666, Japan. furuta.akihisa@twmu.ac.jp.

OBJECTIVE The objective of this study was to evaluate the long-term surgical results of transposition of the great arteries with left ventricular outflow tract obstruction. METHODS We conducted a retrospective study of patients with transposition of the great arteries or double outlet right ventricle with left ventricular outflow tract obstruction undergoing biventricular repair between 1980 and 2017. RESULTS One hundred and eleven patients were enrolled and classified into five groups: atrial switch (n = 20), arterial switch (n = 12), Nikaidoh (n = 7), Rastelli (n = 48), and REV operation groups (n = 24). Early mortality was highest in Nikaidoh group (29%). Median follow-up was 18.2 years. Long-term survival was by far lowest in Nikaidoh group and comparable among the other 4 groups. Freedom from reoperation at 20 years was lowest in Rastelli group (32.1%) due to right ventricular outflow tract-related reoperations. While having no recurrence of left ventricular outflow tract obstruction, the arterial switch operation group had a high proportion of substantial neo-aortic regurgitation (29%). CONCLUSIONS The long-term survival was satisfactory regardless of the surgical technique except Nikaidoh group. The surgical option for transposition of the great arteries with left ventricular outflow tract obstruction should be selected based on the features of the respective procedures.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006330 Heart Defects, Congenital Developmental abnormalities involving structures of the heart. These defects are present at birth but may be discovered later in life. Congenital Heart Disease,Heart Abnormalities,Abnormality, Heart,Congenital Heart Defect,Congenital Heart Defects,Defects, Congenital Heart,Heart Defect, Congenital,Heart, Malformation Of,Congenital Heart Diseases,Defect, Congenital Heart,Disease, Congenital Heart,Heart Abnormality,Heart Disease, Congenital,Malformation Of Heart,Malformation Of Hearts
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000069278 Arterial Switch Operation Surgical procedure for anatomical correction of transposed great arteries (e.g., DOUBLE OUTLET RIGHT VENTRICLE). Arterial Switch Procedure,Arterial Switch Technique,Atrial Switch Operation,Atrial Switch Procedure,Atrial Switch Repair,Atrial Switch Technique,Double-Switch Operation,Double-Switch Procedure,Double-Switch Technique,Jatene Operation,Jatene Procedure,Jatene Technique,Mustard Operation,Mustard Procedure,Mustard Repair,Rastelli Operation,Rastelli Procedure,Rastelli Repair,Rastelli Technique,Senning Operation,Senning Procedure,Arterial Switch Operations,Arterial Switch Procedures,Arterial Switch Techniques,Atrial Switch Operations,Atrial Switch Procedures,Atrial Switch Repairs,Atrial Switch Techniques,Double Switch Operation,Double Switch Procedure,Double Switch Technique,Double-Switch Operations,Double-Switch Procedures,Double-Switch Techniques,Operation, Arterial Switch,Operation, Atrial Switch,Operation, Double-Switch,Operation, Jatene,Operation, Mustard,Operation, Rastelli,Operation, Senning,Operations, Arterial Switch,Operations, Atrial Switch,Operations, Double-Switch,Procedure, Arterial Switch,Procedure, Atrial Switch,Procedure, Double-Switch,Procedure, Jatene,Procedure, Mustard,Procedure, Rastelli,Procedure, Senning,Procedures, Arterial Switch,Procedures, Atrial Switch,Procedures, Double-Switch,Repair, Atrial Switch,Repair, Mustard,Repair, Rastelli,Repairs, Atrial Switch,Technique, Arterial Switch,Technique, Atrial Switch,Technique, Double-Switch,Technique, Jatene,Technique, Rastelli,Techniques, Arterial Switch,Techniques, Atrial Switch,Techniques, Double-Switch
D001158 Arteries The vessels carrying blood away from the heart. Artery
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D014188 Transposition of Great Vessels A congenital cardiovascular malformation in which the AORTA arises entirely from the RIGHT VENTRICLE, and the PULMONARY ARTERY arises from the LEFT VENTRICLE. Consequently, the pulmonary and the systemic circulations are parallel and not sequential, so that the venous return from the peripheral circulation is re-circulated by the right ventricle via aorta to the systemic circulation without being oxygenated in the lungs. This is a potentially lethal form of heart disease in newborns and infants. Dextro-TGA,Dextrotransposition of Great Vessels,Levo-Looped Transposition of the Great Arteries,Levo-TGA,Levotransposition of Great Vessels,Dextro-Looped Transposition of the Great Arteries,Transposition of Great Arteries,Dextro Looped Transposition of the Great Arteries,Dextro TGA,Dextro-TGAs,Great Arteries Transposition,Great Arteries Transpositions,Great Vessels Dextrotransposition,Great Vessels Dextrotranspositions,Great Vessels Levotransposition,Great Vessels Levotranspositions,Great Vessels Transposition,Great Vessels Transpositions,Levo Looped Transposition of the Great Arteries,Levo TGA,Levo-TGAs
D014694 Ventricular Outflow Obstruction Occlusion of the outflow tract in either the LEFT VENTRICLE or the RIGHT VENTRICLE of the heart. This may result from CONGENITAL HEART DEFECTS, predisposing heart diseases, complications of surgery, or HEART NEOPLASMS. Obstruction, Ventricular Outflow,Outflow Obstruction, Ventricular,Ventricular Outflow Obstructions
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes

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