Congenitally Corrected Transposition of the Great Arteries: Ventricular Function at the Time of Systemic Atrioventricular Valve Replacement Predicts Long-Term Ventricular Function
The objective was to evaluate the systemic ventricular ejection fraction (SVEF) at the time of systemic atrioventricular valve (SAVV) replacement as a predictor of SVEF ≥1 year after surgery in patients with congenitally corrected transposition of the great arteries (CCTGA). Progressive SAVV regurgi...
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| Veröffentlicht in: | Journal of the American College of Cardiology 2011-05, Vol.57 (20), p.2008-2017 |
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| container_title | Journal of the American College of Cardiology |
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| creator | MONGEON, François-Pierre CONNOLLY, Heidi M DEARANI, Joseph A ZHUO LI WARNES, Carole A |
| description | The objective was to evaluate the systemic ventricular ejection fraction (SVEF) at the time of systemic atrioventricular valve (SAVV) replacement as a predictor of SVEF ≥1 year after surgery in patients with congenitally corrected transposition of the great arteries (CCTGA).
Progressive SAVV regurgitation causes systemic ventricular failure in CCTGA patients, who are commonly referred late for intervention. Survival after surgery is poor when the pre-operative SVEF is |
| doi_str_mv | 10.1016/j.jacc.2010.11.021 |
| format | Article |
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Progressive SAVV regurgitation causes systemic ventricular failure in CCTGA patients, who are commonly referred late for intervention. Survival after surgery is poor when the pre-operative SVEF is <44%.
We retrospectively reviewed 46 patients (pre-operative SVEF ≥ 40% in 27 patients and <40% in 19 patients) with 2 good-sized ventricles, a morphologically right systemic ventricle, and SAVV regurgitation requiring surgery. Median follow-up was not different in patients with a pre-operative SVEF ≥ 40% (8.8 years) or <40% (7.7 years, p = 0.36).
Pre-operative SVEF was the only independent predictor of ≥ 1-year post-operative SVEF (p < 0.0001). The late SVEF was preserved (defined as ≥ 40%) in 63% of patients who underwent surgery with an SVEF ≥ 40% compared with 10.5% of patients who underwent surgery with an SVEF <40%. Pre-operative variables associated with late mortality were an SVEF ≤ 40%, a subpulmonary ventricular systolic pressure ≥ 50 mm Hg, atrial fibrillation, and New York Heart Association functional class III to IV.
Post-operative systemic ventricular function after SAVV replacement can be predicted from the pre-operative SVEF. For best results, operation should be considered at an earlier stage, before the SVEF falls below 40% and the subpulmonary ventricular systolic pressure rises above 50 mm Hg.</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/j.jacc.2010.11.021</identifier><identifier>PMID: 21565637</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier</publisher><subject>Adolescent ; Adult ; Aged ; Biological and medical sciences ; Cardiology ; Cardiology. Vascular system ; Cardiovascular disease ; Child ; Child, Preschool ; Confidence intervals ; Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava ; Coronary vessels ; Diuretics ; Enzymes ; Female ; Heart ; Heart attacks ; Humans ; Hypertension ; Male ; Medical imaging ; Medical sciences ; Middle Aged ; Morphology ; Mortality ; Multivariate analysis ; Predictive Value of Tests ; Retrospective Studies ; Stroke Volume - physiology ; Surgery ; Survival analysis ; Time Factors ; Transposition of Great Vessels - physiopathology ; Transposition of Great Vessels - surgery ; Tricuspid Valve Insufficiency - physiopathology ; Tricuspid Valve Insufficiency - surgery ; Ventricular Function - physiology ; Young Adult</subject><ispartof>Journal of the American College of Cardiology, 2011-05, Vol.57 (20), p.2008-2017</ispartof><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited May 17, 2011</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24182632$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21565637$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>MONGEON, François-Pierre</creatorcontrib><creatorcontrib>CONNOLLY, Heidi M</creatorcontrib><creatorcontrib>DEARANI, Joseph A</creatorcontrib><creatorcontrib>ZHUO LI</creatorcontrib><creatorcontrib>WARNES, Carole A</creatorcontrib><title>Congenitally Corrected Transposition of the Great Arteries: Ventricular Function at the Time of Systemic Atrioventricular Valve Replacement Predicts Long-Term Ventricular Function</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description>The objective was to evaluate the systemic ventricular ejection fraction (SVEF) at the time of systemic atrioventricular valve (SAVV) replacement as a predictor of SVEF ≥1 year after surgery in patients with congenitally corrected transposition of the great arteries (CCTGA).
Progressive SAVV regurgitation causes systemic ventricular failure in CCTGA patients, who are commonly referred late for intervention. Survival after surgery is poor when the pre-operative SVEF is <44%.
We retrospectively reviewed 46 patients (pre-operative SVEF ≥ 40% in 27 patients and <40% in 19 patients) with 2 good-sized ventricles, a morphologically right systemic ventricle, and SAVV regurgitation requiring surgery. Median follow-up was not different in patients with a pre-operative SVEF ≥ 40% (8.8 years) or <40% (7.7 years, p = 0.36).
Pre-operative SVEF was the only independent predictor of ≥ 1-year post-operative SVEF (p < 0.0001). The late SVEF was preserved (defined as ≥ 40%) in 63% of patients who underwent surgery with an SVEF ≥ 40% compared with 10.5% of patients who underwent surgery with an SVEF <40%. Pre-operative variables associated with late mortality were an SVEF ≤ 40%, a subpulmonary ventricular systolic pressure ≥ 50 mm Hg, atrial fibrillation, and New York Heart Association functional class III to IV.
Post-operative systemic ventricular function after SAVV replacement can be predicted from the pre-operative SVEF. For best results, operation should be considered at an earlier stage, before the SVEF falls below 40% and the subpulmonary ventricular systolic pressure rises above 50 mm Hg.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular disease</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Confidence intervals</subject><subject>Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava</subject><subject>Coronary vessels</subject><subject>Diuretics</subject><subject>Enzymes</subject><subject>Female</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Morphology</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>Predictive Value of Tests</subject><subject>Retrospective Studies</subject><subject>Stroke Volume - physiology</subject><subject>Surgery</subject><subject>Survival analysis</subject><subject>Time Factors</subject><subject>Transposition of Great Vessels - physiopathology</subject><subject>Transposition of Great Vessels - surgery</subject><subject>Tricuspid Valve Insufficiency - physiopathology</subject><subject>Tricuspid Valve Insufficiency - surgery</subject><subject>Ventricular Function - physiology</subject><subject>Young Adult</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpt0VtrFDEUAOAgit1W_4APEhDxadZcJpfxbVlsFRZadO3rkM2c0SyZyZhkCvu7_INm7UqL-BQ4-c6Ng9ArSpaUUPl-v9wba5eMHAN0SRh9ghZUCF1x0ainaEEUFxUljTpD5yntCSFS0-Y5OmNUSCG5WqBf6zB-h9Fl4_0Br0OMYDN0eBvNmKaQXHZhxKHH-Qfgqwgm41XMEB2kD_gWxhydnb2J-HIe7R9bxNFu3QDHvK-HlGFwFq8KDXePMm6NvwP8BSZvLAzlA99E6JzNCW_KUNUW4vDfFi_Qs974BC9P7wX6dvlxu_5Uba6vPq9Xm2piUudqR5Qh0moQ3Q76RnVSc854Qxk3nWJcqU43vCMNJ7zWGna91EIpVhPFDBeEX6B393WnGH7OkHI7uGTBezNCmFOrpRRcEqqKfPOP3Ic5jmW4lspakJo2ihb1-qTm3QBdO0U3mHho_16jgLcnYJI1vi83sC49uJpqJssKvwHEUZxp</recordid><startdate>20110517</startdate><enddate>20110517</enddate><creator>MONGEON, François-Pierre</creator><creator>CONNOLLY, Heidi M</creator><creator>DEARANI, Joseph A</creator><creator>ZHUO LI</creator><creator>WARNES, Carole A</creator><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20110517</creationdate><title>Congenitally Corrected Transposition of the Great Arteries: Ventricular Function at the Time of Systemic Atrioventricular Valve Replacement Predicts Long-Term Ventricular Function</title><author>MONGEON, François-Pierre ; CONNOLLY, Heidi M ; DEARANI, Joseph A ; ZHUO LI ; WARNES, Carole A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p268t-b07a06c8e5dbef97d6833239123ad72377d893d09303488ebf6857724072a3503</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Cardiology</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular disease</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Confidence intervals</topic><topic>Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava</topic><topic>Coronary vessels</topic><topic>Diuretics</topic><topic>Enzymes</topic><topic>Female</topic><topic>Heart</topic><topic>Heart attacks</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Morphology</topic><topic>Mortality</topic><topic>Multivariate analysis</topic><topic>Predictive Value of Tests</topic><topic>Retrospective Studies</topic><topic>Stroke Volume - physiology</topic><topic>Surgery</topic><topic>Survival analysis</topic><topic>Time Factors</topic><topic>Transposition of Great Vessels - physiopathology</topic><topic>Transposition of Great Vessels - surgery</topic><topic>Tricuspid Valve Insufficiency - physiopathology</topic><topic>Tricuspid Valve Insufficiency - surgery</topic><topic>Ventricular Function - physiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>MONGEON, François-Pierre</creatorcontrib><creatorcontrib>CONNOLLY, Heidi M</creatorcontrib><creatorcontrib>DEARANI, Joseph A</creatorcontrib><creatorcontrib>ZHUO LI</creatorcontrib><creatorcontrib>WARNES, Carole A</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>MONGEON, François-Pierre</au><au>CONNOLLY, Heidi M</au><au>DEARANI, Joseph A</au><au>ZHUO LI</au><au>WARNES, Carole A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Congenitally Corrected Transposition of the Great Arteries: Ventricular Function at the Time of Systemic Atrioventricular Valve Replacement Predicts Long-Term Ventricular Function</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>2011-05-17</date><risdate>2011</risdate><volume>57</volume><issue>20</issue><spage>2008</spage><epage>2017</epage><pages>2008-2017</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><coden>JACCDI</coden><abstract>The objective was to evaluate the systemic ventricular ejection fraction (SVEF) at the time of systemic atrioventricular valve (SAVV) replacement as a predictor of SVEF ≥1 year after surgery in patients with congenitally corrected transposition of the great arteries (CCTGA).
Progressive SAVV regurgitation causes systemic ventricular failure in CCTGA patients, who are commonly referred late for intervention. Survival after surgery is poor when the pre-operative SVEF is <44%.
We retrospectively reviewed 46 patients (pre-operative SVEF ≥ 40% in 27 patients and <40% in 19 patients) with 2 good-sized ventricles, a morphologically right systemic ventricle, and SAVV regurgitation requiring surgery. Median follow-up was not different in patients with a pre-operative SVEF ≥ 40% (8.8 years) or <40% (7.7 years, p = 0.36).
Pre-operative SVEF was the only independent predictor of ≥ 1-year post-operative SVEF (p < 0.0001). The late SVEF was preserved (defined as ≥ 40%) in 63% of patients who underwent surgery with an SVEF ≥ 40% compared with 10.5% of patients who underwent surgery with an SVEF <40%. Pre-operative variables associated with late mortality were an SVEF ≤ 40%, a subpulmonary ventricular systolic pressure ≥ 50 mm Hg, atrial fibrillation, and New York Heart Association functional class III to IV.
Post-operative systemic ventricular function after SAVV replacement can be predicted from the pre-operative SVEF. For best results, operation should be considered at an earlier stage, before the SVEF falls below 40% and the subpulmonary ventricular systolic pressure rises above 50 mm Hg.</abstract><cop>New York, NY</cop><pub>Elsevier</pub><pmid>21565637</pmid><doi>10.1016/j.jacc.2010.11.021</doi><tpages>10</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Biological and medical sciences Cardiology Cardiology. Vascular system Cardiovascular disease Child Child, Preschool Confidence intervals Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava Coronary vessels Diuretics Enzymes Female Heart Heart attacks Humans Hypertension Male Medical imaging Medical sciences Middle Aged Morphology Mortality Multivariate analysis Predictive Value of Tests Retrospective Studies Stroke Volume - physiology Surgery Survival analysis Time Factors Transposition of Great Vessels - physiopathology Transposition of Great Vessels - surgery Tricuspid Valve Insufficiency - physiopathology Tricuspid Valve Insufficiency - surgery Ventricular Function - physiology Young Adult |
| title | Congenitally Corrected Transposition of the Great Arteries: Ventricular Function at the Time of Systemic Atrioventricular Valve Replacement Predicts Long-Term Ventricular Function |
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