Systematic review and meta-analysis of outcomes of anatomic repair in congenitally corrected transposition of great arteries  

作　　者：Arka Chatterjee Neal J Miller Marc G Cribbs Amrita Mukherjee Mark A Law 

机构地区：[1]Division of Cardiovascular Diseases,University of Alabama at Birmingham,Birmingham,AL 35294,United States [2]Department of Pediatric Cardiology,University of Alabama at Birmingham,Birmingham,AL 35294,United States [3]Department of Epidemiology,University of Alabama at Birmingham School of Public health,Birmingham,AL 35233,United States

出　　处：《World Journal of Cardiology》2020年第8期427-436,共10页世界心脏病学杂志（英文版）（电子版）

摘　　要：BACKGROUND Treatment of congenitally corrected transposition of great arteries(cc-TGA)with anatomic repair strategy has been considered superior due to restoration of the morphologic left ventricle in the systemic circulation.However,data on long term outcomes are limited to single center reports and include small sample sizes.AIM To perform a systematic review and meta-analysis for observational studies reporting outcomes on anatomic repair for cc-TGA.METHODS MEDLINE and Scopus databases were queried using predefined criteria for reports published till December 31,2017.Studies reporting anatomic repair of minimum 5 cc-TGA patients with at least a 2 year follow up were included.Metaanalysis was performed using Comprehensive meta-analysis v3.0 software.RESULTS Eight hundred and ninety-five patients underwent anatomic repair with a pooled follow-up of 5457.2 patient-years(PY).Pooled estimate for operative mortality was 8.3%[95%confidence interval(CI):6.0%-11.4%].0.2%(CI:0.1%-0.4%)patients required mechanical circulatory support postoperatively and 1.7%(CI:1.1%-2.4%)developed post-operative atrioventricular block requiring a pacemaker.Patients surviving initial surgery had a transplant free survival of 92.5%(CI:89.5%-95.4%)per 100 PY and a low rate of need for pacemaker(0.3/100 PY;CI:0.1-0.4).84.7%patients(CI:79.6%-89.9%)were found to be in New York Heart Association(NYHA)functional class I or II after 100 PY follow up.Total re-intervention rate was 5.3 per 100 PY(CI:3.8-6.8).CONCLUSION Operative mortality with anatomic repair strategy for cc-TGA is high.Despite that,transplant free survival after anatomic repair for cc-TGA patients is highly favorable.Majority of patients maintain NYHA I/II functional class.However,monitoring for burden of re-interventions specific for operation type is very essential.

关 键 词：Congenitally corrected transposition of great arteries Anatomic repair Double switch operation Atrial switch Rastelli Hemi-Mustard Rastelli Atrio-ventricular block 

分 类 号：R654.2[医药卫生—外科学]