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Ann Thorac Surg 1996;62:199-206
© 1996 The Society of Thoracic Surgeons


Original Articles: Cardiovascular

"Classic" Repair of Congenitally Corrected Transposition and Ventricular Septal Defect

Jean-Luc Termignon, MD, Francine Leca, MD, Pascal R. Vouhé, MD, Françoise Vernant, MD, Olivier M. Bical, MD, Yves Lecompte, MD, Jean-Yves Neveux, MD

Department of Cardiothoracic Surgery, Laënnec Hospital, Paris, France

Accepted for publication March 2, 1996.

Background. This study examined the results of "classic" repair of congenitally corrected transposition of the great arteries and ventricular septal defect.

Methods. From 1974 to 1994, 52 patients underwent a classic complete repair of lesions associated with congenitally corrected transposition. They were divided into two groups: ventricular septal defect plus left ventricular outflow tract obstruction (group I, 37 patients) and isolated ventricular septal defect (group II, 15 patients). Tricuspid plasty or replacement was performed primarily in 1 patient of group I (3%) and in 8 patients of group II (53%).

Results. The overall operative mortality was 15% (8/52 patients), and the incidence of postoperative atrioventricular block was 27% (14/52 patients). Eight patients died secondarily, 5 of heart failure. Survival rates were 83% ± 6% at 1 year and 55% ± 14% at 10 years for group I and 86% ± 9% at 1 year and 71% ± 12% at 10 years for group II (not significant). Redo tricuspid plasty or replacement was performed in 12 patients.

Conclusions. Results of classic complete repair of lesions associated with congenitally corrected transposition are not satisfactory in our experience because (1) the operative mortality and the incidences of tricuspid valve replacement and atrioventricular block are high and (2) secondary heart failure is frequent. However, a retrospective review of morphologic findings shows that "anatomic" complete repairs would not have been feasible in 6 of our patients.


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Invited Commentary
Thomas P. Graham, Jr
Ann. Thorac. Surg. 1996 62: 206. [Extract] [Full Text]



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