What is the clinical evidence from this study?

Study design: Cohort. Population: Congenitally corrected transposition of the great arteries (ccTGA) (n=266). Intervention: Anatomic repair vs. Physiologic repair. Primary outcome: Transplant-free survival at 15 years (p=.568).

What question did this study set out to answer?

To compare long-term survival, reoperation rates, and systemic ventricular and atrioventricular valve function following physiologic versus anatomic repair in children with congenitally corrected transposition of the great arteries.

April 17, 2026European Journal of Cardio-Thoracic Surgery

Anatomic versus physiologic repair in congenitally corrected transposition: a propensity-matched european multicentre study

Q: What are the key findings of this study?

Anatomic repair yielded similar 15-year transplant-free survival compared to physiologic repair in children with congenitally corrected transposition of the great arteries (85% vs 80%; P=0.568).

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Key result

Anatomic ccTGA repair yields similar outcomes to physiologic repair but may improve tricuspid valve function.

P=.568
n=266

Why the study?

Does anatomic repair improve long-term survival or reduce reoperations compared to physiologic repair in pediatric patients with congenitally corrected transposition of the great arteries?

Population

Patients with ccTGA repaired in childhood

Comparison

Anatomic repair vs physiologic repair

Design

Propensity-matched European multicentre study

Authors

JOJelena Pabst von OhainDeutsches Herzzentrum München LAL ArnoldLudwig-Maximilians-Universität München KJKirolos A. JacobUniversity Medical Center Utrecht

Discussion

Member takes

Implication

Similar survival and reoperation after physiologic or anatomic ccTGA repair support equipoise; leaves open whether valve benefits justify added anatomic complexity.

Key Points

To compare long-term survival, reoperation rates, and systemic ventricular and atrioventricular valve function following physiologic versus anatomic repair in children with congenitally corrected transposition of the great arteries.
Retrospective multicentre study across 12 European centres involving 266 patients younger than 18 years who underwent surgical repair between 1990 and 2010.
Optimal 1:1 propensity-score matching was performed based on ventricular septal defect, subpulmonary outflow tract obstruction, systemic tricuspid regurgitation, age, and sex, yielding a matched cohort of 162 patients (81 pairs).
Transplant-free survival at 10 and 15 years was 87 ± 4% (95% CI [79%-95%]) and 80 ± 6% (95% CI [68%-93%]) for physiologic repair versus 85 ± 5% (95% CI [78%-96%]) and 85 ± 5% (95% CI [78%-96%]) for anatomic repair (P = .568).
Freedom from cardiac reoperation at 10 and 15 years was 73 ± 6% (95% CI [62%-85%]) and 56 ± 8% (95% CI [41%-75%]) for physiologic repair compared to 61 ± 8% (95% CI [47%-76%]) and 36 ± 9% (95% CI [26%-62%]) for anatomic repair (P = .279).
Tricuspid valve regurgitation at final follow-up was significantly higher after physiologic repair at 57% (27/47) compared to 17% (12/72) after anatomic repair (P < .001).

Study Design

Type

Cohort (n=266)

Multicenter

Yes

Structured PICO

Does anatomic repair improve long-term survival or reduce reoperations compared to physiologic repair in pediatric patients with congenitally corrected transposition of the great arteries?

Population

266 patients aged <18 years with congenitally corrected transposition of the great arteries who underwent physiologic or anatomic repair, with 162 propensity-matched and followed for up to 15 years.

Exposure

Anatomic repair (correcting the double discordance)

Comparator

Physiologic repair (leaving the right ventricle systemic)

Outcome

Transplant-free survival at 10 and 15 yearshard clinical

Main Result

Absolute Event Rate: 85% vs 80%

p-value: p=.568

Anatomic and physiologic repair of ccTGA in childhood yield similar long-term survival and reoperation rates, but anatomic repair better preserves tricuspid valve function.

Cite This Study

Ohain et al. (2026) conducted a cohort in Congenitally corrected transposition of the great arteries (ccTGA) (n=266). Anatomic repair vs. Physiologic repair was evaluated on Transplant-free survival at 15 years (p=.568). Anatomic repair yielded similar 15-year transplant-free survival compared to physiologic repair in children with congenitally corrected transposition of the great arteries (85% vs 80%; P=0.568).

synapsesocial.com/papers/69e1ce3b5cdc762e9d857522 https://doi.org/10.1093/ejcts/ezag148

Topics

Tricuspid regurgitation

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Implication

Similar survival and reoperation after physiologic or anatomic ccTGA repair support equipoise; leaves open whether valve benefits justify added anatomic complexity.

Anatomic versus physiologic repair in congenitally corrected transposition: a propensity-matched european multicentre study

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Topics

Anatomic versus physiologic repair in congenitally corrected transposition: a propensity-matched european multicentre study

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Topics

Also Consider