Contemporary management and outcomes in congenitally corrected transposition of the great arteries

Shelby Kutty, David A. Danford, Gerhard Paul Diller, Oktay Tutarel

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Congenitally corrected transposition of the great arteries (ccTGA) can occur in isolation, or in combination with other structural cardiac anomalies, most commonly ventricular septal defect, pulmonary stenosis and tricuspid valve disease. Clinical recognition can be challenging, so echocardiography is often the means by which definitive diagnosis is made. The tricuspid valve and right ventricle are on the systemic arterial side of the ccTGA circulation, and are therefore subject to progressive functional deterioration. The natural history of ccTGA is also greatly influenced by the nature and severity of accompanying lesions, some of which require surgical repair. Some management strategies leave the right ventricle as the systemic arterial pump, but carry the risk of worsening heart failure. More complex 'double switch' repairs establish the left ventricle as the systemic pump, and include an atrial baffle to redirect venous return in combination with either arterial switch or Rastelli operation (if a suitable ventricular septal defect permits). Occasionally, the anatomic peculiarities of ccTGA do not allow straightforward biventricular repair, and Fontan palliation is a reasonable option. Regardless of the approach selected, late cardiovascular complications are relatively common, so ongoing outpatient surveillance should be established in an age-appropriate facility with expertise in congenital heart disease care.

Original languageEnglish (US)
JournalHeart
DOIs
StateAccepted/In press - Jan 19 2018

Keywords

  • cardiac magnetic resonance (CMR) imaging
  • complex congenital heart disease
  • congenital heart disease surgery
  • echocardiography
  • heart failure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Contemporary management and outcomes in congenitally corrected transposition of the great arteries'. Together they form a unique fingerprint.

  • Cite this