Zhang Lixin, Wu Yuduo, Xie Jiaoyang, Ruan Yanping, Hao Xiaoyan, Wang Hairui, Zhang Ye, Han Jiancheng, He Yihua, Gu Xiaoyan
Echocardiography Medical Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
J Clin Med. 2025 Jul 28;14(15):5313. doi: 10.3390/jcm14155313.
This study sought to echocardiographic manifestations and the related risk factors affecting the prognosis of isolated congenitally corrected transposition of the great arteries (CCTGA). A total of 143 patients (≥18 years of age) were diagnosed with isolated CCTGA at Anzhen Hospital. The patients were classified as the operation group and the non-operation group depending on whether they had undergone tricuspid valve surgery. The echocardiographic data and follow-up were compared, and the primary outcomes examined were defined as death or heart transplantation. The average age of 143 patients with isolated CCTGA was 39.93 ± 13.50 years. Tricuspid valve surgery was performed in 31 patients with isolated CCTGA, and 112 patients did not undergo tricuspid valve surgery. The incidence of tricuspid valve structural changes in the operation group was 39.1%, and this group had higher numbers of patients with right ventricular diastolic diameter, right ventricular systolic diameter, left atrial dimensions, and regurgitation before surgery compared with the non-operation group ( < 0.05). Follow-up results showed no significant difference in the number of death/heart transplantations, and the incidence of systemic ventricular ejection fraction (SVEF) < 40% between the two groups. The survival rate of the surgery group was higher than that of the non-surgery group, although not statistically significant ( = 0.123). Age, right ventricular end-diastolic diameter, and decreased SVEF at the first diagnosis are independent predictive risk factors for major adverse outcomes. Adult patients with isolated CCTGA may have structural abnormalities in their tricuspid valves. There were no significant differences in the incidence of adverse outcomes, morphological right ventricular systolic dysfunction, and survival between the surgery group and the non-surgery group. However, this study is a retrospective study, and the sample size of the surgical group is relatively small, which may limit the generalizability of the research conclusions. In the future, a prospective, large-scale study will be conducted to evaluate the therapeutic effect of tricuspid valve surgery on such patients.
本研究旨在探讨孤立性先天性矫正型大动脉转位（CCTGA）的超声心动图表现及影响预后的相关危险因素。共有143例（≥18岁）患者在安贞医院被诊断为孤立性CCTGA。根据患者是否接受三尖瓣手术，将其分为手术组和非手术组。比较两组的超声心动图数据及随访情况，将主要结局指标定义为死亡或心脏移植。143例孤立性CCTGA患者的平均年龄为39.93±13.50岁。31例孤立性CCTGA患者接受了三尖瓣手术，112例患者未接受三尖瓣手术。手术组三尖瓣结构改变的发生率为39.1%，与非手术组相比，该组术前右心室舒张末径、右心室收缩末径、左心房内径及反流患者数量更多（P<0.05）。随访结果显示，两组间死亡/心脏移植例数及全身心室射血分数（SVEF）<40%的发生率无显著差异。手术组的生存率高于非手术组，尽管差异无统计学意义（P=0.123）。年龄、首次诊断时的右心室舒张末径及SVEF降低是主要不良结局的独立预测危险因素。成年孤立性CCTGA患者可能存在三尖瓣结构异常。手术组和非手术组在不良结局发生率、形态学右心室收缩功能障碍及生存率方面无显著差异。然而，本研究为回顾性研究，手术组样本量相对较小，这可能会限制研究结论的普遍性。未来将开展前瞻性、大规模研究以评估三尖瓣手术对此类患者的治疗效果。
