Oechslin E, Jenni R
Division of Cardiology, University Hospital, Zurich, Switzerland.
Thorac Cardiovasc Surg. 2000 Aug;48(4):233-7. doi: 10.1055/s-2000-6901.
The atrial switch procedure dramatically improved the prognosis of children with complete transposition of the great arteries (TGA). Overall actuarial survival was approximately 75% after 25 years and was better in patients with simple TGA than in those with complex TGA. Mortality by any cause (16%) and cardiovascular mortality (12% and 13%) were comparable in both centers. Progressive congestive heart failure and sudden death were the principal modes of death. Most of the survivors denied any symptoms or had mild limitations in their daily activities. However, long-term problems in this growing population of adults are challenging and include late arrhythmias (up to two thirds of the patients), systemic ventricular (SV) failure, systemic atrioventricular valve regurgitation and reoperations, such as baffle reconstruction, being the most frequent. Objective assessment of SV function obtained by echocardiography is difficult. It may include fractional area change and tricuspid annular motion. Survivors after an atrial switch procedure are unique and have a good quality of life. However, the definitive and true history of the RV supporting the systemic circulation is not as yet known.
心房调转术显著改善了完全性大动脉转位（TGA）患儿的预后。25年后总体精算生存率约为75%，单纯TGA患者的生存率高于复杂TGA患者。两个中心的任何原因死亡率（16%）和心血管死亡率（12%和13%）相当。进行性充血性心力衰竭和猝死是主要死亡方式。大多数幸存者否认有任何症状或日常活动仅有轻度受限。然而，在这一不断增加的成年人群体中，长期问题具有挑战性，包括晚期心律失常（高达三分之二的患者）、体循环心室（SV）衰竭、体循环房室瓣反流以及再次手术，如最常见的挡板重建。通过超声心动图对SV功能进行客观评估很困难。评估指标可能包括面积变化分数和三尖瓣环运动。心房调转术后的幸存者情况独特，生活质量良好。然而，支持体循环的右心室的确切真实情况尚不清楚。
