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. 2011 Jul;4(2):103-10.
doi: 10.4103/0974-2069.84634.

The role of the Fontan operation in the treatment of congenitally corrected transposition of the great arteries

Tom R Karl  1
Affiliations

The role of the Fontan operation in the treatment of congenitally corrected transposition of the great arteries

Tom R Karl. Ann Pediatr Cardiol. 2011 Jul.

Abstract

Congenitally corrected transposition of the great arteries (ccTGA) is a complex cardiac anomaly with an unfavorable natural history. Surgical treatment has been available for over 50 years. Initial procedures used for ccTGA did not correct atrio-ventricular discordance, leaving the right ventricle in systemic position. In the past two decades anatomic repair has been considered to be a better option. Many cases subjected to anatomic repairs would also be suitable for the Fontan strategy, which probably has a lower initial risk. The rationale for use of the Fontan operation in management of congenitally corrected transposition is discussed in this review, with comparisons to other strategies.

Keywords: AV discordance; Fontan procedure; congenitally corrected transposition; discordant transposition.

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Conflict of interest statement

Conflict of Interest: None declared

Figures

Figure 1
Figure 1
Annual number of indexed PubMed articles (verticle axis) coded as “corrected transposition of the great arteries,” for the period 1970–2010 (horizontal axis)
Figure 2
Figure 2
Time course for development of adverse events in unoperated patients with ccTGA (see text for further characterization)
Figure 3
Figure 3
Coronary pattern encountered in two patient with ccTGA undergoing Senning plus ASO. All coronary branches arise from a single trunk (arrow) in a non-facing sinus, an extremely rare pattern in concordant TGA
Figure 4
Figure 4
Coronary patterns encountered in 20 ccTGA anatomic specimens, some of which might have created difficulties for (but not necessarily precluded) anatomic repair. These included a single coronary from sinus 2, LAD from RCA with paracommissural circumflex branch, and eccentric or intramural/paracommissural coronary origin
See this image and copyright information in PMC

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