Bogers Ad J J C, Head Stuart J, de Jong Peter L, Witsenburg Maarten, Kappetein Arie Pieter
Department of Cardiothoracic Surgery, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
J Cardiothorac Surg. 2010 Sep 28;5:74. doi: 10.1186/1749-8090-5-74.
To investigate the long-term outcome of surgical treatment for congenitally corrected transposition of the great arteries (CCTGA), in patients with biventricular repair with the right ventricle as systemic ventricle.
A total of 32 patients with CCTGA were operated between January 1972 and October 2008. These operations comprised 18 patients with a repair with a normal left ventricular outflow tract, 11 patients with a Rastelli repair of the left ventricle to the pulmonary artery and 3 patients with a cardiac transplantation.
Excluding the cardiac transplantation patients, mean age at operation was 16 years (sd 15 years, range 1 week - 49 years). Median follow-up was 12 years (sd 10 years, range 7 days - 32 years). Survival obtained from Kaplan-Meier analysis at 20 years after surgery was 63% (CI 53-73%). For the non-Rastelli group these data at 20 years were 62% (CI 48-76%) and for the Rastelli group 67% (CI 51-83%). Freedom of reoperation at 20 years was 32% (CI 19-45%) in the overall group. In the non-Rastelli group the data at 20 years were 47% (CI 11-83%) and for the Rastelli group 21% (CI 0-54%) after almost 19 years.
Long term follow up confirms that surgery in CCTGA with the right ventricle as systemic ventricle has a suboptimal survival and limited freedom of reoperation. Death occurred mostly as a result of cardiac failure.
探讨大动脉转位矫正术（CCTGA）在以右心室作为体循环心室进行双心室修复的患者中的长期疗效。
1972年1月至2008年10月期间，共对32例CCTGA患者进行了手术。这些手术包括18例左心室流出道正常的修复手术、11例左心室到肺动脉的Rastelli修复手术以及3例心脏移植手术。
排除心脏移植患者后，手术时的平均年龄为16岁（标准差15岁，范围1周 - 49岁）。中位随访时间为12年（标准差10年，范围7天 - 32年）。术后20年通过Kaplan-Meier分析得出的生存率为63%（置信区间53 - 73%）。非Rastelli组20年时的数据为62%（置信区间48 - 76%），Rastelli组为67%（置信区间51 - 83%）。总体组20年时再次手术的自由度为32%（置信区间19 - 45%）。在非Rastelli组中，经过近19年，20年时的数据为47%（置信区间11 - 83%），Rastelli组为21%（置信区间0 - 54%）。
长期随访证实，以右心室作为体循环心室的CCTGA手术生存率不理想，再次手术的自由度有限。死亡主要是由于心力衰竭。
