Surgical treatment of the concomitant pathology in corrected transposition of great arteries

• Main Authors: O.Ye. Repin, L.S. Maniuc, V.I. Corcea, E.K. Cheptanaru, O.Ye. Maliga, E.I. Virlan, I.V. Cucu
• Format: Article
• Language: English
• Published: TOV Chetverta Khvylia 2016-03-01
• Series: Kardìohìrurgìâ ta Intervencìjna Kardìologìâ
• Subjects: congenitally heart disease; corrected transposition of grate arteries
• Online Access: http://csic.com.ua/images/pdf/2016/1-2016/experience-physiologic-repair-congenitally-corrected-transposition.pdf

The aim – to analyze our experience in the treatment of patients with congenitally corrected transposition of great arteries (CCTGA). Materials and methods. Thirty-nine patients with CCTGA (0.7 %), age from 4 months to 48 years, were observed since 1995 to 2014. Insufficiency of the tricuspid valve was diagnosed in 7 patients, ventricular septal defect (VSD) – in 12, III degree AV blockade – in 5 patients (in 4 cases – primary AV blockade and in one case – after VSD repair), insufficiency of mitral valve – in 3 cases (in one of them as a result of bacterial endocarditis after implantation of the endocardial electrode), pulmonary stenosis – in 5. Rezults. Totally 24 surgeries were performed: correction of systemic valve insufficiency – in 6 patients (plastics – in 4 of them and prosthesis in 2 patients), VSD plastics – 9, pacemaker implantation – 4, mitral valve plastics – 2, pulmonary artery banding – 2, bidirectional Glenn – 1. Surgeries were performed without lethal outcomes. Patients were observed from 8 months till 14 years. Adequate correction of all associated pathology was achieved in all patients. Concerning the progressing of tricuspid valve insufficiency, replacement of it was done in 3 cases. Medical treatment of the progressive heart failure was prescribed to 48 years-old patient. Conclusion. The submitted material confirms the data regarding high risk of the development of AV blockade, tricuspid valve insufficiency, as well as right ventricular failure during 4–5th decade of life. Early revealing and adequate correction of accompanying defects and developing complications allows to achieve satisfactory immediate and long-term results.