Chen Xinxin.Current therapeutic status and recent advances for Congenitally corrected transposition of the great arteries[J].Journal of Clinical Pediatric Surgery,,20():506-511.[doi:10.12260/lcxewkzz.2021.06.002]
Current therapeutic status and recent advances for Congenitally corrected transposition of the great arteries
- Keywords:
- Transposition of Great Vessels/SU; Transposition of Great Vessels/DI; Transposition of Great Vessels/PP; Heart Defects; Congenital/SU; Treatment Outcome
- CLC:
- R541.1;R493.28;R322.11
- Abstract:
- As a complex and rare congenital heart disease,congenitally corrected transposition of the great arteries (ccTGA) is frequently complicated with ventricular septal defect,pulmonary artery stenosis or atresia,tricuspid Ebstein-like malformation and mesocardia.The basic characteristics of its pathological anatomy include atrioventricular discordance and arterioventricular discordance.Physiological correction was performed in 1957 while anatomical correction,namely double reversal surgery,implemented in late 1980s,including atrial switch and arterial switch with satisfactory surgical outcomes.The medium/long-term follow-ups were also satisfactory.After the 21st century,anatomic correction of one and a half ventricles,including Hemi-Mustard,bidirectional Glenn and Rastelli.At the same time,some ccTGA children with ventricular septal defect and pulmonary artery stenosis underwent Fontan operation with decent medium/long-term outcomes.For ccTGA children with intact ventricular septum,pulmonary artery banding and atrial septostomy could effectively retrain the degenerate morphological left ventricle and achieve ultimate anatomical correction.Physiological correction has been gradually abandoned due to its poor medium/long-term outcomes.Anatomical correction has become a major option since it restores normal anatomy and physiology.Fontan procedure has also yielded satisfactory medium/long-term outcomes in patients with high risks for anatomic correction.For surgical treatment of congenital heart disease,anatomical correction not only requires a certain amount of complex surgical experience,but also depends upon the comprehensive strength and philosophy of treatment team.
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Memo
收稿日期:2021-04-13;。
基金项目:广州市高水平临床重点专科
通讯作者:陈欣欣,Email:zingerchen@163.com