Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
5966030 | International Journal of Cardiology | 2015 | 6 Pages |
BackgroundPulmonary outflow tract obstruction (POTO) reduces systemic atrioventricular valve (SAVV) regurgitation severity in congenitally corrected transposition of the great arteries (ccTGA). Therefore, pulmonary artery banding is proposed as a palliative intervention. We aimed to investigate the effect of native or surgically induced POTO on event-free survival, defined as the composite of all-cause mortality, heart transplantation, or congestive heart failure (CHF).Methods and resultsPatients with ccTGA (n = 62; median age 27.5 (IQR 18.4-39.4) years; 39% with POTO) were selected from the Adult Congenital Heart Disease database of a tertiary hospital. At first visit, SAVV regurgitation â¥Â 3/4, systemic RV dysfunction â¥Â moderate, and CHF were present in 26%, 26%, and 15% of patients, respectively. Over a mean follow-up time of 10.1 ± 6.1 years, all-cause mortality, rate of heart transplantation, and CHF were 18%, 8% and 40%, respectively. SAVV regurgitation (HR: 1.99; 95% CI: 1.01-3.92; P = 0.048) and systemic RV dysfunction severity (HR: 1.89; 95% CI: 1.05-3.37; P = 0.033) were associated with the composite endpoint, independently of age at baseline, POTO, Ebstein-like malformation, and systemic RV dilatation. Patients with POTO had lower risk for developing SAVV regurgitation â¥Â 3/4 (HR: 0.18; 95% CI: 0.05-0.58; P = 0.004) and moderate systemic RV dysfunction (HR: 0.34; 95% CI: 0.15-0.78; P = 0.011). When POTO was present, the mean progression-free interval for the composite endpoint increased from 11.2 to 18.1 years (P = 0.035).ConclusionsPOTO is associated with an improved event-free survival in adults with ccTGA.