| Evaluation of Prognostic Factors in Corrected Transposition of the Great Arteries at Mid-term Follow-up |
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Young-Hwan Song1, Hyok-Joo Kwon1, Gi-Beom Kim1, Soo-Jung Kang1, Eun-Jung Bae1, Chung-Il Noh1, Yong-Soo Yun1, Jeong-Ryul Lee2, Yong-Jin Kim2, Joon-Ryang Rho2 |
1Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea
2Department of Thoracic Surgery, College of Medicine, Seoul National University, Seoul, Korea |
| 수정 대혈관 전위 환자에서 예후에 영향을 주는 인자들에 대한 중기적 고찰 |
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송영환1, 권혁주1, 김기범1, 강수정1, 배은정1, 노정일1, 윤용수1, 이정렬2, 김용진2, 노준량2 |
1서울대학교 의과대학 소아과학교실
2서울대학교 의과대학 소아흉부외과학교실 |
Correspondence:
Chung-Il Noh, Email: chungnoh@plaza.snu.ac.kr
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| Abstract |
Purpose
: The prognosis of patients with corrected transposition of the great arteries(C-TGA) is variably affected by associated intracardiac defects, systemic right ventricular function, tricuspid valve competence, and conduction disturbances. This study aims to evaluate the importance of those factors at mid-term follow-up.
Methods
: Medical records of 94 patients(males 58, females 36; mean age at last follow-up, 12? years; mean follow-up duration, 9?.4 years) diagnosed between January 1980 and May 2002 at Seoul National University Children's Hospital were studied retrospectively.
Results
: Among 94 patients, operations were performed in 72 patients(classic operations in 55; double switch operations in 17). Among prognostic factors including associated intracardiac anomalies(at least moderately severe tricuspid insufficiency(TI), ventricular septal defect, pulmonary stenosis and pulmonary atresia), intracardiac operation and complete atrioventricular block, TI was the only significant factor for death(P=0.001), and in turn, Ebstein anomaly and high grade atrioventricular block predicted TI. 20-year survival without TI was 77%, but only 35% with TI(P=0.0002); excluding perioperative death, the 20-year survival rates with and without TI were 48% and 87% respectively(P= 0.008). There was no statistical difference in 20-year survival rate or association with TI between classic and double switch operation.
Conclusion
: TI was the major prognostic factor for C-TGA and was associated with Ebstein anomaly and high grade atrioventricular block at mid-term follow-up. Long-term follow-up is required to evaluate other factors, including double switch operations and associated intracardiac defects more exactly. |
| Key Words:
Corrected transposition of the great vessels, Tricuspid valve insufficiency |
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