Late failure of systemic ventricle after atrial correction for transposition of great arteries

• Published in: European journal of cardio-thoracic surgery Vol. 3; no. 2; pp. 119 - 123
• Main Authors: SIEBENMANN, R, VON SEGESSER, L, SCHNEIDER, K, SCHNEIDER, J, SENNING, A, TURINA, M
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Science B.V 1989; Elsevier Science
• Subjects: Actuarial Analysis; Biological and medical sciences; Cardiology. Vascular system; Child, Preschool; Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava; Female; Follow-Up Studies; Heart; Heart Atria - surgery; Heart Failure - etiology; Heart Failure - mortality; Humans; Incidence; Male; Medical sciences; Myocardial Contraction - physiology; Postoperative Complications - mortality; Survival Rate; Time Factors; Transposition of Great Vessels - surgery; Heart failure; Corrective surgery; Prognosis; Congenital; Heart disease; Cardiovascular disease; Right ventricular failure; Transposition of the great vessels; Long term
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1016/1010-7940(89)90088-2

The incidence of late systemic ventricular failure (SVF) was determinedin 220 early survivors of atrial correction for transposition of greatarteries (TGA), operated upon between 1964 and 1985. SVF was defined aseither severe heart failure (NYHA class III or IV) or death due to the samecause, in the absence of other haemodynamic disturbances. The actuarialsurvival rate was 96% after 1, 94% after 5 and 87% after 10 years. SVFoccurred in 16/220 patients (7.2%). SVF was more common in complex TGA (TGA+ VSD or PS or both) with 11/99 patients (11%) than in simple TGA with5/121 patients (4.1%), P less than 0.01. Actuarial freedom from SVF was 97%at 5, and 92.5% at 10 years. SVF caused 10/25 (40%) late deaths. SVFoccurred from the 1st postoperative year up to 20 years after correction(average interval 6.3 years). In 1 of 2 patients a systemicatrioventricular (AV) valve annuloplasty did not improve SVF. Hearttransplantation was performed in 2 patients and 1 is on the waiting list.SVF is a rare late complication of atrial correction for TGA with aconstant incidence in the late course. SVF is more common in complexTGA.