Management considerations in the adult with surgically modified d-transposition of the great arteries

Lasya Gaur, Ari Cedars, Gerhard Paul Diller, Shelby Kutty, Stefan Orwat

Research output: Contribution to journalReview articlepeer-review

Abstract

Dextro-transposition of the great arteries (D-TGA) has undergone a significant evolution in surgical repair, leading to survivors with vastly different postsurgical anatomy which in turn guides their long-term cardiovascular morbidity and mortality. Arterial switch repair survivors are limited by a right ventricle in the systemic arterial position, arrhythmia and atrial baffles prone to obstruction or leak. Functional assessment of the systemic right ventricle is complex, requiring multimodality imaging to include specialised echocardiography and cross-sectional imaging (MRI and CT). In the current era, most neonates undergo the arterial switch operation with increasing understanding of near-term and long-term outcomes specific to their cardiac anatomy. Long-term observations of the Lecompte manoeuvre or coronary stenoses following transfer continue, with evolving understanding to improve surveillance. Ultimately, an understanding of postsurgical anatomy, specialised imaging techniques and interventional and electrophysiological procedures is essential to comprehensive care of D-TGA survivors.

Original languageEnglish (US)
Article numbere318833
JournalHeart
DOIs
StateAccepted/In press - 2021

Keywords

  • congenital
  • congenital abnormalities
  • heart defects
  • transposition of great vessels

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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