Survival in atrioventricular discordance.

Area of Science:

• Cardiology
• Congenital Heart Disease
• Adult Congenital Heart Disease

Background:

• Limited data exists on long-term survival for patients with atrioventricular discordance, ventriculoarterial discordance, and two ventricles (corrected transposition).
• Understanding prognostic factors is crucial for managing this complex congenital heart defect population.

Purpose of the Study:

• To evaluate the long-term survival rates of patients diagnosed with corrected transposition.
• To identify clinical variables associated with survival in this patient cohort.

Main Methods:

• Retrospective review of 107 patients with corrected transposition diagnosed between 1951 and 1981.
• Analysis of survival data and associated clinical variables including sex, age, ventricular septal defect, pulmonary stenosis, dextrocardia, atrioventricular valve insufficiency, and heart block.

Main Results:

• Overall survival was 70% at five years and 64% at ten years post-diagnosis.
• Left atrioventricular valve insufficiency was the only variable consistently associated with decreased long-term survival.
• Ventricular septal defect and pulmonary stenosis did not significantly impact overall survival, though pulmonary stenosis showed a protective effect when a VSD was present.

Conclusions:

• Left atrioventricular valve insufficiency is a significant negative prognostic factor in patients with corrected transposition.
• Atrioventricular valve replacement should be considered for patients with hemodynamically significant left atrioventricular valve insufficiency.