Key result
Double switch operation linked to improved long-term survival and functional capacity over physiologic repair in ccTGA.
Why the study?
The optimal surgical treatment for congenitally corrected transposition of the great arteries remains uncertain, with a need to evaluate physiologic versus anatomic repair approaches.
Answers are grounded in this paper and cite their sources.
Double switch may reduce systemic RV failure in cTGA; leaves open optimal repair strategy pending higher-level evidence.
The seeking for the optimal surgical treatment of congenitally corrected transposition of the great arteries (cTGA) is ongoing. Physiologic (conventional) repair approaches, leaving the morphologic right ventricle (MRV) on the systemic circulation side, cause systemic ventricle and tricuspid valve failure, particularly in the long-term. Double Switch operations (anatomic repair) were aimed to convert the morphologic left ventricle to systemic ventricle and MRV to pulmonic ventricle. Gradual improvement in the early and midterm results of double switch operations in the last 20 years rendered anatomic repair to become a preferred procedure. Thanks to the preservation of ventricular functions through anatomic repair, patients with congenitally cTGA may survive longer with normal/near normal functional capacity. However, studies with larger sample size and longer follow-up duration are required to establish a more definite judgement.
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Tayyar Sarıoğlu (2018) conducted a review in congenitally corrected transposition of the great arteries (cTGA). Double switch operations (anatomic repair) vs. Physiologic (conventional) repair was evaluated. Double switch operations (anatomic repair) may improve long-term survival and functional capacity compared to physiologic repair in congenitally corrected transposition of the great arteries.
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