Transposition of the great arteries: long-term outcome and current management

• Published in: Current cardiology reports 2005-07, Vol.7 (4), p.299-304
• Main Author: Murphy, Jr, Daniel J
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Arrhythmias, Cardiac - etiology; Arrhythmias, Cardiac - mortality; Cardiac Surgical Procedures - methods; Cause of Death; Death, Sudden, Cardiac - etiology; Exercise Tolerance; Female; Heart Failure - etiology; Heart Failure - mortality; Humans; Hypertension, Pulmonary - etiology; Hypertension, Pulmonary - mortality; Male; Pregnancy; Quality of Life; Transposition of Great Vessels - complications; Transposition of Great Vessels - mortality; Transposition of Great Vessels - physiopathology; Transposition of Great Vessels - surgery; Ventricular Dysfunction, Right - etiology; Ventricular Dysfunction, Right - mortality
• ISSN: 1523-3782; 1534-3170
• DOI: 10.1007/s11886-005-0052-0

There is a large group of young adults who survived atrial baffle repair of transposition of the great arteries. Most survivors are asymptomatic, although nearly all have decreased exercise capacity. Loss of sinus rhythm and atrial arrhythmias are common and increase with age. There is concern about the ability of the right ventricle to function long term as a systemic pump, and recent publications have highlighted right ventricular dysfunction in this patient population. Sudden death and congestive heart failure are the main causes of death, and outcomes beyond 30 years are unknown. Pulmonary artery banding, late arterial switch, and cardiac transplantation are employed when intractable arrhythmias or right ventricular failure threaten survival or quality of life.