The variability in pattern, presentation, and outcomes in the management of congenital corrected transposition of the great artery(ccTGA) : A Systematic Review and Meta-analysis.
Main Article Content
Keywords
ccTGA, meta-analysis, children, complex, heterogeneity
Abstract
Background: Congenitally corrected transposition of the great arteries (ccTGA) is a rare congenital heart disease with varying regional reports in management approach. The meta-analysis is aimed to document various regional differences in the pattern, presentation, and outcomes in the management of congenitally corrected transposition of the great artery(ccTGA)
Methodology: Search engines for published articles on ccTGA were used in the meta-analysis. This includes PubMed, Google Scholar, Web of Science, Medline, and Africa Journal Online. Articles published between 2001 and 2024 were recruited of which the last search was done in August 2024. Selected articles were highlighted and screened by means of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Statistical heterogeneity was assessed with the I2 statistics.
Results: Fifty-one full articles were screened from the initial four hundred and eighty citations. A total of 37 studies were further excluded from the 51 studies after further screening for incomplete data, case reports, non-English language reportage, and studies from autopsy findings. The resultant 14 studies were presented in PRISMA. The statistical significance was observed as evidenced by the significance heterogeneity identified in the selected studies.
Conclusion: The review had shown that children with ccTGA presented with varying features with some chromosomal correlates. Management options are directed towards a high index of suspicion, early intervention, and prompt surgical care to avert the numerous complications that follow the disease.
References
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5.Bove EL. Congenitally corrected transposition of the great arteries: ventricle to pulmonary artery connection strategies. Semin Thorac Cardiovasc Surg 1995;7:139-44.
6.Hosseinpour A-R, McCarthy KP, Griselli M, Sethia B, Ho SY. Congenitally corrected transposition: size of the pulmonary trunk and septal malalignment. Ann Thorac Surg 2004;77:2163–6
7.Helsen F, De Meester P, Van Keer J, Gabriels C, Van De Bruaene A, Herijgers P, et al. Pulmonary outflow obstruction protects against heart failure in adults with congenitally corrected transposition of the great arteries. Int J Cardiol. 2015 ;196:1-6. doi: 10.1016/j.ijcard.2015.05.142.
8.Nabil Dib, Jean-Marc Sellal, Matilde Karakachoff, Ismail Bouhout, Vincent Chauvette, Nancy Poirier, et al. Causes of Death in Congenitally Corrected Transposition of Great Arteries, JACC: Advances 2024; 3:101036,
9.Fuller S. Comparing long-term sequelae of the systemic right ventricle: an overview of single versus biventricular arrangements Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu, 2022; 25 :2-10
10. Mccombe A, Touma F, Jackson D, et al. Sudden cardiac death in adults with congenitally corrected transposition of the great arteries Open Heart 2016, 3: e000407
11. van Dissel AC, Opotowsky AR, Burchill LJ, Aboulhosn J, Grewal J, Lubert AM,et al. End-stage heart failure in congenitally corrected transposition of the great arteries: a multicentre study. Eur Heart J. 2023 Sep 7;44(34):3278-3291. doi: 10.1093/eurheartj/ehad511.
12.Wells G, Shea B, O’Connell J, Robertson J, Peterson V, Welch V, et al. The NewcastleOttawa scale (NOS) for assessing the quality of nonrandomised studies in meta-analysis. Available at http://www.ohri.ca/ programs/clinical_epidemiology/oxfordasp. Accessed June 21, 2016.
13.Weixler VHM, Kramer P, Murin P, Romanchenko O, Cho MY, Ovroutski S, Hübler M, Berger F, Photiadis J. Anatomic Repair of Congenitally Corrected Transposition: Reappraisal of Eligibility Criteria. Pediatr Cardiol. 2022 Aug;43(6):1214-1222. doi: 10.1007/s00246-022-02841-z. Epub 2022 Feb 11. PMID: 35149898; PMCID: PMC9294026.
14.He Q, Shen H, Shao X, Chen W, Wu Y, Liu R, Li S, Zhou Z. Cardiovascular Phenotypes Profiling for L-Transposition of the Great Arteries and Prognosis Analysis. Front Cardiovasc Med. 2022 Jan 21;8:781041. doi: 10.3389/fcvm.2021.781041. PMID: 35127856; PMCID: PMC8814104
15. Rebecca RH, Kimberly JW, Megan W, Tiffany RL, Andrew R, Sunkyung Y. Anatomic Repair of Congenitally Corrected Transposition of the Great Arteries is Associated With Significant Mid- and Long-term Electrophysiologic Morbidity. Circulation 2020; 142; https://doi.org/10.1161/circ.142.suppl_3.14198
16.Gerardo P, Digilio MC, Capolino R, Zorzi AD, Toscano A, Sarkozy A, et al. Familial recurrence of heart defects in subjects with congenitally corrected transposition of the great arteries. Am J Med Genet A. 2005 Aug 30;137(2):176-80. doi: 10.1002/ajmg.a.30859. PMID: 16059940.
17.Benjamin S, Kirklin JK, Pavnica J, Tresler M, Johnson WH Jr, Cleveland DC, Mauchley DC, Dabal RJ. Congenitally Corrected Transposition Presenting in the First Year of Life: Survival and Fate of the Systemic Right Ventricle. World J Pediatr Congenit Heart Surg. 2019 Jan;10(1):42-49. doi: 10.1177/2150135118813125. PMID: 30760124.
18.Shagun S, Jacobsen RM, Woods RK, Mitchell ME, Cava JR, Ghanayem NS, Frommelt PC, Bartz PJ, Tweddell JS. Anatomic Repair of Congenitally Corrected Transposition of the Great Arteries: Single-Center Intermediate-Term Experience. Pediatr Cardiol. 2017 Dec;38(8):1696-1702. doi: 10.1007/s00246-017-1715-5. Epub 2017 Sep 16. PMID: 28918529
19. Sachin T, Bansal A, Choudhary SK, Kothari SS, Juneja R, Saxena A, Airan B. Results of Fontan operation in patients with congenitally corrected transposition of great arteries†. Interact Cardiovasc Thorac Surg. 2016 Feb;22(2):188-93. doi: 10.1093/icvts/ivv316. Epub 2015 Nov 20. PMID: 26590305.
20. Jennifer Y, Varma SK, Malhotra A, Menahem S. Congenital complete heart block: single tertiary centre experience. Heart Lung Circ. 2012 Nov;21(11):666-70. doi: 10.1016/j.hlc.2012.05.784. Epub 2012 Jun 29. PMID: 22749374.
21. Vladimir S, Kuipers I, Koolbergen D, Rijlaarsdam M, Hruda J, Blom N et al. Mid-term results of bidirectional cavopulmonary anastomosis and hemi-Mustard procedure in anatomical correction of congenitally corrected transposition of the great arteries. Eur J Cardiothorac Surg. 2012 Oct;42(4):680-4. doi: 10.1093/ejcts/ezs055. Epub 2012 Mar 7. PMID: 22402454.
22. Vincent T KH, Erez E, Roten L, Muyskens S, Sebastian V, Tsao C, Nikaidoh H. Senning With Aortic Translocation and Anatomic Repair for Congenitally Corrected Transposition. Ann Thorac Surg. 2021 May;111(5):1607-1612. doi: 10.1016/j.athoracsur.2020.07.056. Epub 2020 Oct 10. PMID: 33045205.
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Jan 10, 2025
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Chinawa, J., Chinawa, A., Uwaezuoke, N., & Igoche, P. (2025). The variability in pattern, presentation, and outcomes in the management of congenital corrected transposition of the great artery(ccTGA) : A Systematic Review and Meta-analysis. Nigerian Medical Journal, 65(6), 851–864. https://doi.org/10.60787/nmj.v65i6.655
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