PDF(Pubmed)
Abstract：
Background: Congenitally corrected transposition of the great arteries (cc-TGA) is a defect characterized by arterio-ventricular and atrioventricular disconcordance. Most patients have co-existing cardiac abnormalities that warrant further treatment. Some patients do not require surgical intervention, but most undergo physiological repair or anatomical surgery, which enables them to reach adulthood. Aims: We aimed to evaluate mortality risk factors in patients with cc-TGA. Results: We searched the PubMed database and included 10 retrospective cohort studies with at least a 5-year follow-up time with an end-point of cardiovascular death a minimum of 30 days after surgery. We enrolled 532 patients, and 83 met the end-point of cardiovascular death or equivalent event. As a risk factor for long-term mortality, we identified New York Heart Association (NYHA) class ≥III/heart failure hospitalization (OR = 10.53; 95% CI, 3.17-34.98) and systemic ventricle dysfunction (SVD; OR = 4.95; 95% CI, 2.55-9.64). We did not show history of supraventricular arrhythmia (OR = 2.78; 95% CI, 0.94-8.24), systemic valve regurgitation ≥moderate (SVR; OR = 4.02; 95% Cl, 0.84-19.18), and pacemaker implantation (OR = 1.48; 95% Cl, 0.12-18.82) to affect the long-term survival. In operated patients only, SVD (OR = 4.69; 95% CI, 2.06-10.71) and SVR (OR = 3.85; 95% CI, 1.5-9.85) showed a statistically significant impact on survival. Conclusions: The risk factors for long-term mortality for the entire cc-TGA population are NYHA class ≥III/heart failure hospitalization and systemic ventricle dysfunction. In operated patients, systemic ventricle dysfunction and at least moderate systemic valve regurgitation were found to affect survival.
摘要：
背景：先天性矫正的大动脉转位（cc-TGA）是一种缺陷，其特征是动室和房室不一致。大多数患者有共存的心脏异常，需要进一步治疗。有些病人不需要手术干预，但大多数都接受生理修复或解剖手术，使他们能够成年。目的：我们旨在评估cc-TGA患者的死亡危险因素。结果：我们搜索了PubMed数据库，并纳入了10项回顾性队列研究，随访时间至少为5年，终点为手术后至少30天的心血管死亡。我们招募了532名患者，83例符合心血管死亡或同等事件的终点.作为长期死亡的危险因素，我们确定了纽约心脏协会(NYHA)≥III级/心力衰竭住院(OR=10.53;95%CI,3.17~34.98)和全身心室功能障碍(SVD;OR=4.95;95%CI,2.55~9.64).我们没有显示室上性心律失常的病史（OR=2.78;95％CI，0.94-8.24），系统性瓣膜返流≥中度（SVR；OR=4.02；95%Cl，0.84-19.18)，和起搏器植入(OR=1.48；95%Cl，0.12-18.82）影响长期生存率。仅在手术患者中，SVD（OR=4.69；95％CI，2.06-10.71）和SVR（OR=3.85；95％CI，1.5-9.85）对生存率有统计学意义。结论：整个cc-TGA人群长期死亡的危险因素是NYHA≥III级/心力衰竭住院和全身心室功能障碍。在手术患者中，发现全身性心室功能障碍和至少中度的全身性瓣膜反流会影响生存率。
