ACC/AHA recommendations for surgical intervention in L-transposition of the great arteries: Difference between revisions
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{{L-transposition of the great arteries}} | {{L-transposition of the great arteries}} | ||
{{Transposition of the great vessels}} | {{Transposition of the great vessels}} | ||
{{CMG}}; '''Associate Editor(s)-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.B.B.S.]] [mailto: | {{CMG}}; '''Associate Editor(s)-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.B.B.S.]] [mailto:psingh13579@gmail.com]; {{CZ}}; [[User:KeriShafer|Keri Shafer, M.D.]] [mailto:kshafer@bidmc.harvard.edu]; '''Assistant Editor(s)-In-Chief:''' [[Kristin Feeney|Kristin Feeney, B.S.]] [mailto:kfeeney@elon.edu] | ||
==Overview== | ==Overview== | ||
ACC/AHA recommends different surgical options for patients with congenitally corrected/Levo-transposition of the great arteries | 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 | ==ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease (DO NOT EDIT)<ref name="pmid18997168">{{cite journal| author=Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA et al.| title=ACC/AHA 2008 Guidelines for the Management of Adults with Congenital Heart Disease: Executive Summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines for the management of adults with congenital heart disease). | journal=Circulation | year= 2008 | volume= 118 | issue= 23 | pages= 2395-451 | pmid=18997168 | doi=10.1161/CIRCULATIONAHA.108.190811 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18997168 }} </ref><ref name="pmid19038677">{{cite journal| author=Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA et al.| title=ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. | journal=J Am Coll Cardiol | year= 2008 | volume= 52 | issue= 23 | pages= e1-121 | pmid=19038677 | doi=10.1016/j.jacc.2008.10.001 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19038677 }} </ref>== | ||
{{ | ===Surgical Intervention (DO NOT EDIT)<ref name="pmid18997168">{{cite journal| author=Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA et al.| title=ACC/AHA 2008 Guidelines for the Management of Adults with Congenital Heart Disease: Executive Summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines for the management of adults with congenital heart disease). | journal=Circulation | year= 2008 | volume= 118 | issue= 23 | pages= 2395-451 | pmid=18997168 | doi=10.1161/CIRCULATIONAHA.108.190811 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18997168 }} </ref><ref name="pmid19038677">{{cite journal| author=Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA et al.| title=ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. | journal=J Am Coll Cardiol | year= 2008 | volume= 52 | issue= 23 | pages= e1-121 | pmid=19038677 | doi=10.1016/j.jacc.2008.10.001 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19038677 }} </ref> === | ||
''' | {| class="wikitable" | ||
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| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | |||
|- | |||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' Surgeons with training and expertise in CHD should perform operations for patients with CCTGA for the following indications: | |||
|- | |||
| bgcolor="LightGreen"|'''a.''' Unrepaired CCTGA and severe AV valve regurgitation. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' | |||
|- | |||
| bgcolor="LightGreen"|'''b.''' Anatomic repair with atrial and arterial level switch/Rastelli repair in cases in which the left ventricle is functioning at systemic pressures. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' | |||
|- | |||
| bgcolor="LightGreen"|'''c.''' Simple VSD closure when the VSD is not favorable for left ventricle–to–aorta baffling or is restrictive. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' | |||
|- | |||
| bgcolor="LightGreen"|'''d.''' LV–to–pulmonary artery conduit in rare cases with LV dysfunction and severe LV outflow obstruction. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' | |||
|- | |||
| bgcolor="LightGreen"|'''e.''' Evidence of moderate or progressive systemic AV valve regurgitation. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' | |||
|- | |||
| bgcolor="LightGreen"|'''f.''' Conduit obstruction with systemic or nearly systemic RV pressures and/or RV dysfunction after anatomic repair. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' | |||
|- | |||
| bgcolor="LightGreen"|'''g.''' Conduit obstruction and systemic or suprasystemic LV pressures in a patient with nonanatomic correction. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' | |||
|- | |||
| bgcolor="LightGreen"|'''h.''' Moderate or severe AR/neo-AR and onset of ventricular dysfunction or progressive ventricular dilatation. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki> | |||
|} | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[CME Category::Cardiology]] | |||
[[Category:Disease]] | |||
[[Category:Cardiology]] | |||
[[Category:Congenital heart disease]] | |||
[[Category:Pediatrics]] | |||
Latest revision as of 19:05, 14 March 2016
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Levo-transposition of the great arteries Microchapters | |
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Differentiating Levo-transposition of the great arteries from other Diseases | |
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Treatment | |
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Case Studies | |
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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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FDA on ACC/AHA recommendations for surgical intervention in L-transposition of the great arteries | |
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CDC on ACC/AHA recommendations for surgical intervention in L-transposition of the great arteries | |
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Blogs on ACC/AHA recommendations for surgical intervention in L-transposition of the great arteries | |
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Transposition of the great vessels Microchapters |
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Classification |
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Differentiating Transposition of the great vessels from other Diseases |
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Diagnosis |
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Treatment |
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Surgery |
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Case Studies |
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ACC/AHA recommendations for surgical intervention in L-transposition of the great arteries On the Web |
|
American Roentgen Ray Society Images of ACC/AHA recommendations for surgical intervention in L-transposition of the great arteries |
|
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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Blogs on ACC/AHA recommendations for surgical intervention in L-transposition of the great arteries |
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
- ↑ 1.0 1.1 Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA; et al. (2008). "ACC/AHA 2008 Guidelines for the Management of Adults with Congenital Heart Disease: Executive Summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines for the management of adults with congenital heart disease)". Circulation. 118 (23): 2395–451. doi:10.1161/CIRCULATIONAHA.108.190811. PMID 18997168.
- ↑ 2.0 2.1 Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA; et al. (2008). "ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". J Am Coll Cardiol. 52 (23): e1–121. doi:10.1016/j.jacc.2008.10.001. PMID 19038677.