ACC/AHA recommendations for surgical intervention in L-transposition of the great arteries

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Levo-transposition of the great arteries Microchapters

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Transposition of the great vessels Microchapters

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ACC/AHA recommendations for surgical intervention in L-transposition of the great arteries On the Web

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American Roentgen Ray Society Images of ACC/AHA recommendations for surgical intervention in L-transposition of the great arteries

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Ongoing Trials at Clinical Trials.gov

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FDA on ACC/AHA recommendations for surgical intervention in L-transposition of the great arteries

CDC on ACC/AHA recommendations for surgical intervention in L-transposition of the great arteries

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Cafer Zorkun, M.D., Ph.D. [3]; Keri Shafer, M.D. [4]; Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [5]

Overview

ACC/AHA recommends different surgical options for patients with congenitally corrected/Levo-transposition of the great arteries. In some cases, the technically challenging "double switch operation" has been successfully performed to restore the normal blood flow through the appropriate morphologic ventricles.

ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease (DO NOT EDIT)[1][2]

Surgical Intervention (DO NOT EDIT)[1][2]

Class I
"1. Surgeons with training and expertise in CHD should perform operations for patients with CCTGA for the following indications:
a. Unrepaired CCTGA and severe AV valve regurgitation. (Level of Evidence: B)
b. Anatomic repair with atrial and arterial level switch/Rastelli repair in cases in which the left ventricle is functioning at systemic pressures. (Level of Evidence: B)
c. Simple VSD closure when the VSD is not favorable for left ventricle–to–aorta baffling or is restrictive. (Level of Evidence: B)
d. LV–to–pulmonary artery conduit in rare cases with LV dysfunction and severe LV outflow obstruction. (Level of Evidence: B)
e. Evidence of moderate or progressive systemic AV valve regurgitation. (Level of Evidence: B)
f. Conduit obstruction with systemic or nearly systemic RV pressures and/or RV dysfunction after anatomic repair. (Level of Evidence: B)
g. Conduit obstruction and systemic or suprasystemic LV pressures in a patient with nonanatomic correction. (Level of Evidence: B)
h. Moderate or severe AR/neo-AR and onset of ventricular dysfunction or progressive ventricular dilatation. (Level of Evidence: B)"

References

Cardiology


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