J Korean Pediatr Soc.  2003 Feb;46(2):154-161.

Evaluation of Prognostic Factors in Corrected Transposition of the Great Arteries at Mid-term Follow-up

• Song YH
• Kwon HJ
• Kim GB
• Kang SJ
• Bae EJ
• Noh CI
• Yun YS
• Lee JR
• Kim YJ
• Rho JR

Abstract

PURPOSE
The prognosis of patients with corrected transposition of the great arteries(C-TGA) is variably affected by associated intracardiac defects, systemic right ventricular function, tricuspid valve competence, and conduction disturbances. This study aims to evaluate the importance of those factors at mid-term follow-up.
METHODS
Medical records of 94 patients(males 58, females 36; mean age at last follow-up, 12+/-9 years; mean follow-up duration, 9+/-6.4 years) diagnosed between January 1980 and May 2002 at Seoul National University Children's Hospital were studied retrospectively.
RESULTS
Among 94 patients, operations were performed in 72 patients(classic operations in 55; double switch operations in 17). Among prognostic factors including associated intracardiac anomalies(at least moderately severe tricuspid insufficiency(TI), ventricular septal defect, pulmonary stenosis and pulmonary atresia), intracardiac operation and complete atrioventricular block, TI was the only significant factor for death(P=0.001), and in turn, Ebstein anomaly and high grade atrioventricular block predicted TI. 20-year survival without TI was 77%, but only 35% with TI(P=0.0002); excluding perioperative death, the 20-year survival rates with and without TI were 48% and 87% respectively(P= 0.008). There was no statistical difference in 20-year survival rate or association with TI between classic and double switch operation.
CONCLUSION
TI was the major prognostic factor for C-TGA and was associated with Ebstein anomaly and high grade atrioventricular block at mid-term follow-up. Long-term follow-up is required to evaluate other factors, including double switch operations and associated intracardiac defects more exactly.

Keyword

Corrected transposition of the great vessels; Tricuspid valve insufficiency

MeSH Terms

Arteries*
Atrioventricular Block
Ebstein Anomaly
Female
Follow-Up Studies*
Heart Septal Defects, Ventricular
Humans
Medical Records
Mental Competency
Prognosis
Pulmonary Valve Stenosis
Retrospective Studies
Seoul
Survival Rate
Tricuspid Valve
Tricuspid Valve Insufficiency
Ventricular Function, Right