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[Corrected transposition of the great arteries in patients over 65]
F Attie1, M Rijlaarsdam, C Zabal
1Instituto Nacional de Cardiología Ignacio Chávez, México, D.F.
Insights
This study details three elderly patients over 65 with corrected transposition of the great arteries (cTGA). Long-term survival is rare due to associated defects and complications like tricuspid regurgitation.
Area of Science:
- Cardiology
- Congenital Heart Disease
- Adult Congenital Heart Disease
Background:
- Corrected transposition of the great arteries (cTGA) is a complex congenital heart defect.
- While theoretically compatible with normal life, long-term survival is often limited by associated anomalies or complications.
Observation:
- The study describes three cases of cTGA in patients aged over 65 years.
- Case 1: Atrial situs solitus, pulmonary valvular stenosis, calcification, small ventricular septal defect, and ischemic heart disease, leading to death at 80.
- Case 2: Atrial situs solitus, ventricular septal defect, atrial septal defect, and pulmonary hypertension.
- Case 3: Atrial situs inversus with mild tricuspid regurgitation.
Findings:
- This highlights the possibility of extended survival into older age with cTGA, even with significant associated defects.
- Complications such as pulmonary stenosis, septal defects, pulmonary hypertension, and tricuspid regurgitation were observed.
- Cardiac failure and ischemic heart disease were noted as causes of mortality.
Implications:
- These cases demonstrate that long-term survival in adult congenital heart disease, specifically cTGA, is achievable.
- Early identification and management of associated defects and potential complications are crucial for improving outcomes in adult cTGA patients.
- Further research is warranted to understand the factors contributing to prolonged survival and to optimize management strategies for this rare adult congenital heart condition.
Abstract:
Three cases with corrected transposition of the great arteries in patients older than 65 years are described. Two had atrial situs solitus and one atrial situs inversus. One had pulmonary valvular stenosis with valvular calcification and a small ventricular septal defect in association with ischemic heart disease. This patient died due to cardiac failure at the age of 80 years. The second case was associated with ventricular septal defect, atrial septal defect and pulmonary hypertension. The third patient presented with mild tricuspid regurgitation. Although this congenital heart malformation is theoretically compatible with normal life, few patients have long survival because of associated congenital defects or the subsequent development of tricuspid regurgitation or atrioventricular block.