Transposition of the great vessels natural History, complications & prognosis
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Transposition of the great vessels Microchapters |
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Classification |
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Differentiating Transposition of the great vessels from other Diseases |
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Diagnosis |
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Treatment |
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Surgery |
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Case Studies |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Cafer Zorkun, M.D., Ph.D. [3]; Keri Shafer, M.D. [4]; Kristin Feeney, B.S. [5]
Overview
If left untreated, over 50 percent of infants with transposition of the great arteries will die in the first month of life. 90 percent will die in the first year. Common complications of TGA include congestive heart failure, arrhythmia, pulmonary artery stenosis and aortic regurgitation. The prognosis for patients with TGA is generally excellent following surgical correction with survival rates greater than 90%. Without treatment, 30% of infants die within the first week of life, 50% will die in the first month, 70% will die in the first 6 months and 90% of infants will die before the end of the first year.
Natural History
If left untreated, over 50 percent of infants with transposition of the great arteries will die in the first month of life. 90 percent will die in the first year.
Complications
Common complications of TGA include:[1]
- Congestive heart failure
- Arrhythmia
- Eisenmenger syndrome (irreversible and progressive pulmonary vascular obstructive disease)
- Pulmonary artery stenosis
- Coronary artery ostial obstruction (coronary ischemia)
- Rarely can lead to supravalvular aortic stenosis
- Aortic root dilation
- Aortic regurgitation
Prognosis
- Without treatment, 30% of infants die within the first week of life, 50% will die in the first month, 70% will die in the first 6 months and 90% of infants will die before the end of the first year.[2][3]
- The prognosis for patients with D-TGA is generally excellent following surgical correction with survival rates greater than 90%.
- The ASO has the best long-term survival and functional outcome.
- Studies have reported a >95% rate survival at fifteen to twenty-five years following discharge.
- The prognosis on simple d-TGA depends mainly on the presence of cardiac shunts such as FO, ASD, VSD, and DA.
- Presence of one or more of the above mentioned defects are present, blood will be mixed, allowing a small amount of oxygen to be delivered to the body, giving an opportunity to the newborn to survive long enough to receive corrective surgery.
References
- ↑ Gatzoulis MA, Walters J, McLaughlin PR, Merchant N, Webb GD, Liu P (October 2000). "Late arrhythmia in adults with the mustard procedure for transposition of great arteries: a surrogate marker for right ventricular dysfunction?". Heart. 84 (4): 409–15. doi:10.1136/heart.84.4.409. PMC 1729461. PMID 10995411.
- ↑ Hutter PA, Kreb DL, Mantel SF, Hitchcock JF, Meijboom EJ, Bennink GB (October 2002). "Twenty-five years' experience with the arterial switch operation". J. Thorac. Cardiovasc. Surg. 124 (4): 790–7. doi:10.1067/mtc.2002.120714. PMID 12324738.
- ↑ Tobler D, Williams WG, Jegatheeswaran A, Van Arsdell GS, McCrindle BW, Greutmann M, Oechslin EN, Silversides CK (June 2010). "Cardiac outcomes in young adult survivors of the arterial switch operation for transposition of the great arteries". J. Am. Coll. Cardiol. 56 (1): 58–64. doi:10.1016/j.jacc.2010.03.031. PMID 20620718.