title: The long-term outcomes of physiologic repair for ccTGA (congenitally corrected transposition of the great arteries).
abstract: OBJECTIVE
  The short-term outcome of physiologic repair for congenitally corrected transposition of the great arteries (ccTGA) is generally considered favorable; however, the long-term outcome is the greatest problem, especially with regard to right ventricular (RV) function and tricuspid regurgitation (TR). Although tricuspid valve replacement (TVR) appears to be a realistic choice for treating severe TR, determining the timing of TVR may be difficult.
  
  
  METHODS
  We carried out a retrospective analysis of the long-term outcomes of physiologic repair for ccTGA focusing on patients with TVR. The study involved 23 patients after physiologic repair 10 or more years prior. There were 9 TVR cases in 5 pediatric patients (before age 18) and 4 adult patients.
  
  
  RESULTS
  There were two late deaths; however, there was no case related with cardiac events. Overall survival at 10 and 20 years were 95.5 and 90.2 %, respectively, and 7 of 8 patients after TVR were NYHA class I or II. No patient has presented postoperative complications in the form of bleeding or embolism after TVR with mechanical valve.
  
  
  CONCLUSIONS
  An analysis of the results of physiologic repair for ccTGA showed that the long-term outcome was overall favorable. To maintain RV function, early TVR may be a reasonable option, even in the management of patients during childhood.
authors.affiliation: Department of Cardiovascular Surgery, Tenri Hospital, 200 Mishima-cho, Tenri, Nara, 632-8552, Japan, khirose@tenriyorozu.jp.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Hirose
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nishina
authors.forename: Naoki
authors.initials: N
authors.lastname: Kanemitsu
authors.forename: Akihiro
authors.initials: A
authors.lastname: Mizuno
authors.forename: Daisuke
authors.initials: D
authors.lastname: Yasumizu
authors.forename: Masashi
authors.initials: M
authors.lastname: Yada
authors.forename: Yohei
authors.initials: Y
authors.lastname: Onga
authors.forename: Kazuo
authors.initials: K
authors.lastname: Yamanaka
mesh_terms: D000293:Adolescent; D000328:Adult; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D000080041:Congenitally Corrected Transposition of the Great Arteries; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000503:physiopathology / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D014188:Transposition of Great Vessels / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014262:Tricuspid Valve Insufficiency / Q000503:physiopathology / Q000601:surgery; D016278:Ventricular Function, Right / Q000502:physiology; D014945:Wound Healing / Q000502:physiology