Back to Search
Start Over
Congenitally Corrected Transposition of the Great Arteries: Anatomic, Physiologic Repair, and Palliation
Congenitally Corrected Transposition of the Great Arteries: Anatomic, Physiologic Repair, and Palliation
- Source :
- Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual. 22:32-42
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- Congenitally corrected transposition of the great arteries (ccTGA) is a lesion that rarely occurs in isolation. The presenting physiology of ccTGA is predominantly secondary to the concurrent cardiac lesions; however, as the child ages, unrepaired ccTGA results in progressive failure of the morphologic right ventricle under the strain of maintaining a systemic pressure. Repair of ccTGA was initially focused on rectification of the underlying physiologic aberrations, but in recent years, the focus of repair has shifted toward anatomic correction to avoid failure of the morphologic right ventricle. This anatomic repair is commonly associated with improved long-term mortality at the cost of increased short-term mortality. Key preoperative considerations such as morphologic left ventricular pressure, tricuspid valve competency, and out flow tract obstructions can assist in determining the optimal repair for individual patients. An alternative, single ventricle, pathway has been proposed for any patient without optimal preoperative anatomy to improve long-term survival. Adjunctive repair options including pulmonary artery banding and one-and-a-half ventricle repairs have also been proposed to augment the survival curves.
- Subjects :
- medicine.medical_specialty
Transposition of Great Vessels
030204 cardiovascular system & hematology
Fontan Procedure
Pulmonary artery banding
Lesion
03 medical and health sciences
0302 clinical medicine
Coronary Circulation
Internal medicine
Humans
Medicine
Survival analysis
Tricuspid valve
business.industry
Infant, Newborn
Treatment Outcome
medicine.anatomical_structure
Congenitally corrected transposition
030228 respiratory system
Ventricle
Great arteries
Pediatrics, Perinatology and Child Health
Ventricular pressure
Cardiology
Surgery
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 10929126
- Volume :
- 22
- Database :
- OpenAIRE
- Journal :
- Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual
- Accession number :
- edsair.doi.dedup.....046f6ea9f62f5286c8ca6a3510906f42
- Full Text :
- https://doi.org/10.1053/j.pcsu.2019.02.008