Abstract：
For transposition of the great arteries with unrestricted ventricular septal defect and pulmonary stenosis, double-root translocation is reported to reconstruct ideal double artery roots with growth potential. However, prospective long-term studies describing the long-term outcomes are still scarce. Therefore, the aim was to assess development of double artery roots, hemodynamics, and freedom from death and heart failure 17 years after double-root translocation, Rastelli, and Réparation à l\'Etage Ventriculaire procedures.
In this prospective population-based study, 266 patients with transposition of the great arteries/ventricular septal defect/pulmonary stenosis (from July 2004 to August 2021) were consecutively included before surgery. All patients were divided into 3 groups based on the type of operation: double-root translocation (174), Rastelli (68), and Réparation à l\'Etage Ventriculaire (24), who accepted postoperative evaluations annually. Generalized linear mixed model analysis was performed to determine growth potential of artery roots.
Longitudinal repeated computed tomography measurements show the pulmonary root has significantly increased diameter (0.62 [0.03] mm/y, P < .001) over time and an adequate Z-score (-0.18) at the last follow-up only in the double-root translocation group. The pressure gradients of double outflow tracts in the double-root translocation group were the least among 3 groups. The probabilities of freedom from death/heart failure at the 15th year were 73.1%, 59.3%, and 60.9% in the double-root translocation, Rastelli, and Réparation à l\'Etage Ventriculaire groups, respectively (double-root translocation vs Rastelli, P = .026; double-root translocation vs Réparation à l\'Etage Ventriculaire, P = .009; Rastelli vs Réparation à l\'Etage Ventriculaire, P = .449).
By reconstructing ideal double artery roots, double-root translocation can provide postoperative long-term excellent hemodynamics and minimal death and heart failure for patients with transposition of the great arteries/ventricular septal defect/pulmonary stenosis.
In this prospective population-based study, 266 patients with transposition of the great arteries/ventricular septal defect/pulmonary stenosis (from July 2004 to August 2021) were consecutively included before surgery. All patients were divided into 3 groups based on the type of operation: double-root translocation (174), Rastelli (68), and Réparation à l\'Etage Ventriculaire (24), who accepted postoperative evaluations annually. Generalized linear mixed model analysis was performed to determine growth potential of artery roots.
Longitudinal repeated computed tomography measurements show the pulmonary root has significantly increased diameter (0.62 [0.03] mm/y, P < .001) over time and an adequate Z-score (-0.18) at the last follow-up only in the double-root translocation group. The pressure gradients of double outflow tracts in the double-root translocation group were the least among 3 groups. The probabilities of freedom from death/heart failure at the 15th year were 73.1%, 59.3%, and 60.9% in the double-root translocation, Rastelli, and Réparation à l\'Etage Ventriculaire groups, respectively (double-root translocation vs Rastelli, P = .026; double-root translocation vs Réparation à l\'Etage Ventriculaire, P = .009; Rastelli vs Réparation à l\'Etage Ventriculaire, P = .449).
By reconstructing ideal double artery roots, double-root translocation can provide postoperative long-term excellent hemodynamics and minimal death and heart failure for patients with transposition of the great arteries/ventricular septal defect/pulmonary stenosis.
摘要：
目的：对于无限制室间隔缺损和肺动脉狭窄的大动脉转位，据报道，双根易位可以重建具有生长潜力的理想双动脉根。然而,描述长期结果的前瞻性长期研究仍然很少。因此,目的是评估双动脉根的发育，血流动力学,双根易位17年后免于死亡和心力衰竭，拉斯泰利,和“埃蒂奇脑室程序”。
方法：在这项基于人群的前瞻性研究中，术前连续纳入266例大动脉转位/室间隔缺损/肺动脉狭窄患者（2004年7月至2021年8月）。所有患者根据手术类型分为3组：双根易位（174），拉斯泰利（68），和埃蒂奇脑室(24)，每年接受术后评估。进行广义线性混合模型分析以确定动脉根的生长潜力。
结果：纵向重复计算机断层扫描测量显示肺根直径显着增加（0.62[0.03]mm/y，P<.001）随着时间的推移，仅在双根易位组中在最后一次随访时具有足够的Z评分（-0.18）。双根易位组的双流出道压力梯度在3组中最小。第15年免于死亡/心力衰竭的概率为73.1%，59.3%,在双根易位中占60.9%，拉斯泰利,和“埃蒂奇脑室组”分别(双根易位vs拉斯泰利，P=.026；双根易位与脑室分离，P=.009；拉斯泰利vs埃太奇脑室，P=.449）。
结论：通过重建理想的双动脉根，对于大动脉转位/室间隔缺损/肺动脉狭窄患者，双根转位可提供术后长期良好的血流动力学，并将死亡和心力衰竭降至最低。
方法：在这项基于人群的前瞻性研究中，术前连续纳入266例大动脉转位/室间隔缺损/肺动脉狭窄患者（2004年7月至2021年8月）。所有患者根据手术类型分为3组：双根易位（174），拉斯泰利（68），和埃蒂奇脑室(24)，每年接受术后评估。进行广义线性混合模型分析以确定动脉根的生长潜力。
结果：纵向重复计算机断层扫描测量显示肺根直径显着增加（0.62[0.03]mm/y，P<.001）随着时间的推移，仅在双根易位组中在最后一次随访时具有足够的Z评分（-0.18）。双根易位组的双流出道压力梯度在3组中最小。第15年免于死亡/心力衰竭的概率为73.1%，59.3%,在双根易位中占60.9%，拉斯泰利,和“埃蒂奇脑室组”分别(双根易位vs拉斯泰利，P=.026；双根易位与脑室分离，P=.009；拉斯泰利vs埃太奇脑室，P=.449）。
结论：通过重建理想的双动脉根，对于大动脉转位/室间隔缺损/肺动脉狭窄患者，双根转位可提供术后长期良好的血流动力学，并将死亡和心力衰竭降至最低。
