Incidence of dysrhythmias in congenitally corrected transposition of the great arteries.
We reviewed hospital records of 45 children with corrected transposition of the great arteries (c-TGA) to determine the incidence and outcome of congenital and postoperative dysrhythmias seen in this congenital anomaly. Our study comprised 45 patients (12 girls, 33 boys). The mean age of the patients at initial evaluation was 3.4 +/- 3.7 years, and they were followed for a mean period of 3.5 +/- 4 years. Forty-three patients (95%) with c-TGA had associated intracardiac defects. Two patients (5%) did not have any cardiac defects. In 31 (69%) of the 45 patients, ventricular septal defect (VSD) was present, while the remaining 14 patients (31%) had intact ventricular septum. VSD repair was done in 17 of 31 patients. Different types of dysrhythmias were detected in 19 of 45 patients. Six patients (13%) presented initially with congenital complete atrioventricular block (AVB) and five patients with postoperative complete ve AVB. Pacemaker implantation was required for 11 patients with complete AVB. In eight patients, ventricular and supraventricular ectopic beats, left bundle-branch block (LBBB) and first-degree AVB were determined but therapy was not required. TWenty-five (58%) of 43 patients with intracardiac defects underwent different surgical procedures. Permanent pacemaker implantation was required for five patients (29%) after VSD repair (17 patients) due to postoperative complete AVB. The incidence of congenital AVB in 14 patients with intact ventricular septum was found to be high (29%) in comparison to the group with VSD (6%). Patients diagnosed as c-TGA with or without cardiac defects should be followed carefully during their clinical course to identify and treat different types of dysrhythmias that can appear at any time.
Kafali
Gülden
G
Department of Pediatrics, Hacettepe University, Faculty of Medicine, Ankara, Turkey.
Elsharshari
Huda
H
Ozer
Sema
S
Celiker
Alpay
A
Ozme
Sencan
S
Demircin
Metin
M
D000293:Adolescent; D001145:Arrhythmias, Cardiac / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006327:Heart Block / Q000209:etiology*; D006330:Heart Defects, Congenital / Q000150:complications; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D014188:Transposition of Great Vessels / Q000150:complications* / Q000601:surgery*