End-stage heart failure in congenitally corrected transposition of the great arteries: a multicentre study
Authors' conclusion
Patients with ccTGA have variable deterioration to end-stage heart failure or death over time, commonly between their fifth and sixth decades. Predictors include arrhythmic and CHF events and severe RV dysfunction but not anatomy or need for tricuspid valve surgery.
Study context
- Population
- Adults with congenitally corrected transposition of the great arteries (ccTGA) seen at a congenital heart disease centremedian follow-up 8.7 years
- Participants
- 558 adults
- Outcome
- Composite of:
- Mechanical circulatory support
- Heart transplantation
- Death
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
Event rate of primary outcome
15.4 per 1000 person-years
Mechanical circulatory support implantations
11
Transplantations
12
Deaths
52
Observational data: associations, not effects.
Further findings
| Outcome | Moderate/severe RV dysfunction and tricuspid regurgitation | Mild/less RV dysfunction and tricuspid regurgitation | P value |
|---|---|---|---|
| Primary outcome by RV dysfunction and tricuspid regurgitation severity | 31 of 110 | 13 of 181 | P < 0.001 |
Anatomic complexity, prior tricuspid valve surgery, subpulmonic obstruction
- Outcomes not different
Independent predictors of primary outcome (multivariable Cox regression)
- Older age, prior congestive heart failure (CHF) admission and severe right ventricular (RV) dysfunction were independent predictors
Childhood surgery vs age- and sex-matched controls
- More adverse outcomes after childhood surgery
Original publication
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