Outcomes for congenitally corrected transposition of great arteries using various surgical techniques: a systematic review and network meta-analysis.

INTRODUCTION

Congenitally corrected transposition of the great arteries (ccTGA) is a rare disorder. Here, we evaluated the effectiveness of physiological, anatomical and Fontan repair techniques for ccTGA.

METHODS

A systematic database search in PubMed, Embase and Cochrane Central Register of Controlled Trials was conducted from inception to 5 June 2023. Random-effects network meta-analysis was performed, comparing mortality, postoperative arrhythmias, reintervention after definitive surgery and transplant-free survival in patients undergoing physiological, anatomical and Fontan repair.

FINDINGS: A total of 1,209 patients were included from nine studies. Fontan repair was associated with a higher rate of transplant-free survival (absolute risk [AR] 0.999 (±0.0101), 95% confidence interval [CI]) and reintervention after definitive surgery (AR 0.098 (±0.067), 95% CI), whereas the difference for mortality and postoperative arrhythmias did not reach statistical significance.

CONCLUSIONS

Fontan repair is significantly better than anatomical or physiological repair in terms of transplant-free survival and also had a better rank probability for overall survival and reintervention after definitive surgery.