Key result
Multimodal LV rehabilitation restores ventricular function, enabling successful double-switch repair in ccTGA.
Why the study?
In congenitally corrected transposition of the great arteries, pulmonary artery banding may prepare the morphologic LV for systemic work before double-switch repair, but the development of ventricular dysfunction threatens surgical candidacy.
Case Report (n=1)
Multimodal rehabilitation (biventricular resynchronization, heart failure therapy, and pulmonary artery band loosening) and pressure-volume reassessment can reverse ventricular dysfunction during left ventricular training and preserve candidacy for double-switch repair in congenitally corrected transposition of the great arteries.
BACKGROUND: In congenitally corrected transposition of the great arteries, pulmonary artery banding (PAB) may prepare the morphologic left ventricle (LV) for systemic work before double-switch repair; however, development of ventricular dysfunction threatens candidacy. CASE SUMMARY: 2-year-old boy with corrected transposition of the great arteries and Ebstein-like tricuspid valve malformation developed biventricular dysfunction after PAB tightening, atrial septal stenting, and single-site epicardial pacing for heart block. Biventricular resynchronization therapy, heart failure therapy, and PAB loosening restored ventricular function. Pressure-volume analysis demonstrated comparable ventricular contractility, preserved LV diastolic function, and loading tolerance before uncomplicated double-switch repair. DISCUSSION: Multimodal rehabilitation and serial reassessment may preserve anatomic repair candidacy when reversible dysfunction complicates LV training. TAKE-HOME MESSAGES: Ventricular dysfunction during LV preparation warrants evaluation for reversible contributors, including pacing-associated dyssynchrony and excessive pressure loading, before abandonment of anatomic repair. Following multimodal rehabilitation, serial imaging and pressure-volume analysis can assess LV systolic recovery, diastolic reserve, and loading tolerance for systemic work.
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Martens et al. (2026) conducted a case report in Congenitally corrected transposition of the great arteries with Ebstein-like tricuspid valve malformation and biventricular dysfunction (n=1). Multimodal left ventricular rehabilitation (biventricular resynchronization therapy, heart failure therapy, and pulmonary artery band loosening) was evaluated on Restoration of ventricular function and successful double-switch repair. Multimodal rehabilitation (CRT, heart failure therapy, and PAB loosening) restored ventricular function and enabled uncomplicated double-switch repair in a 2-year-old boy (n=1) with ccTGA.
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