Left ventricular retraining and anatomic correction in teenage patient with congenitally corrected transposition of the great arteries

Osami Honjo, Masaaki Kawada, Teiji Akagi, Yasuhiro Kotani, Kozo Ishino, Shunji Sano

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Left ventricular (LV) retraining followed by anatomical repair would be a superior alternative in patients with congenitally corrected transposition (ccTGA) having a deconditioned morphologically left ventricle (MLV); however, LV retraining in older children is a challenging task. A retraining process of the MLV in a teenage patient with ccTGA is reported here. Cardiac catheterization at 7 years of age revealed low pressure of the MLV (33/4 mm Hg) and a LV to right ventricular pressure ratio (LVp/RVp ratio) of 0.32. The first pulmonary artery banding (PAB) was performed at 10 years of age. Although the LVp/RVp ratio reached 0.68, there was no evidence of adequate LV hypertrophy. The second PAB was performed 2 years after the initial PAB, resulting in an increase in the LVp/RVp ratio to 0.93 and an adequate LV hypertrophy. The double switch procedure was successfully performed at 13 years of age. Although the ejection fraction of the MLV mildly decreased, the patient has been doing well during a follow-up period of 4 years. The MLV in the teenage patient with ccTGA was successfully trained using a retraining strategy and has sustained systemic circulation after anatomical repair.

Original languageEnglish
Pages (from-to)613-616
Number of pages4
JournalCirculation Journal
Volume71
Issue number4
DOIs
Publication statusPublished - 2007

Keywords

  • Congenitally corrected transposition of the great arteries
  • Double switch operation
  • Left ventricular retraining

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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