Sarıoğlu Tayyar, Arnaz Ahmet
Department of Cardiovascular Surgery, Division of Pediatric Cardiovascular Surgery, Acıbadem Mehmet Ali Aydınlar University, İstanbul, Turkey.
Turk Gogus Kalp Damar Cerrahisi Derg. 2018 Jul 3;26(3):511-518. doi: 10.5606/tgkdc.dergisi.2018.15240. eCollection 2018 Jul.
The seeking for the optimal surgical treatment of congenitally corrected transposition of the great arteries (cTGA) is ongoing. Physiologic (conventional) repair approaches, leaving the morphologic right ventricle (MRV) on the systemic circulation side, cause systemic ventricle and tricuspid valve failure, particularly in the long-term. Double Switch operations (anatomic repair) were aimed to convert the morphologic left ventricle to systemic ventricle and MRV to pulmonic ventricle. Gradual improvement in the early and midterm results of double switch operations in the last 20 years rendered anatomic repair to become a preferred procedure. Thanks to the preservation of ventricular functions through anatomic repair, patients with congenitally cTGA may survive longer with normal/near normal functional capacity. However, studies with larger sample size and longer follow-up duration are required to establish a more definite judgement.
对先天性矫正型大动脉转位（cTGA）最佳手术治疗方法的探索仍在进行中。生理性（传统）修复方法是将形态学右心室置于体循环侧，会导致体循环心室和三尖瓣功能衰竭，尤其是从长期来看。双调转手术（解剖修复）旨在将形态学左心室转变为体循环心室，将形态学右心室转变为肺循环心室。在过去20年里，双调转手术的早期和中期结果逐渐改善，使得解剖修复成为一种首选术式。由于通过解剖修复保留了心室功能，先天性cTGA患者可能以正常/接近正常的功能能力存活更长时间。然而，需要更大样本量和更长随访时间的研究来做出更明确的判断。
