JACC. Case reports · 2026
Multimodal Left Ventricular Rehabilitation Enabling Double-Switch Repair in Congenitally Corrected Transposition of the Great Arteries.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Martens Anna M, Thatte Nikhil, Breitbart Roger E, Kuriakose Emy M, O'Leary Edward, Emani Sitaram M, Kobayashi Ryan L
Аннотация
BACKGROUND: In congenitally corrected transposition of the great arteries, pulmonary artery banding (PAB) may prepare the morphologic left ventricle (LV) for systemic work before double-switch repair; however, development of ventricular dysfunction threatens candidacy.
CASE SUMMARY: 2-year-old boy with corrected transposition of the great arteries and Ebstein-like tricuspid valve malformation developed biventricular dysfunction after PAB tightening, atrial septal stenting, and single-site epicardial pacing for heart block. Biventricular resynchronization therapy, heart failure therapy, and PAB loosening restored ventricular function. Pressure-volume analysis demonstrated comparable ventricular contractility, preserved LV diastolic function, and loading tolerance before uncomplicated double-switch repair.
DISCUSSION: Multimodal rehabilitation and serial reassessment may preserve anatomic repair candidacy when reversible dysfunction complicates LV training.
TAKE-HOME MESSAGES: Ventricular dysfunction during LV preparation warrants evaluation for reversible contributors, including pacing-associated dyssynchrony and excessive pressure loading, before abandonment of anatomic repair. Following multimodal rehabilitation, serial imaging and pressure-volume analysis can assess LV systolic recovery, diastolic reserve, and loading tolerance for systemic work.
CASE SUMMARY: 2-year-old boy with corrected transposition of the great arteries and Ebstein-like tricuspid valve malformation developed biventricular dysfunction after PAB tightening, atrial septal stenting, and single-site epicardial pacing for heart block. Biventricular resynchronization therapy, heart failure therapy, and PAB loosening restored ventricular function. Pressure-volume analysis demonstrated comparable ventricular contractility, preserved LV diastolic function, and loading tolerance before uncomplicated double-switch repair.
DISCUSSION: Multimodal rehabilitation and serial reassessment may preserve anatomic repair candidacy when reversible dysfunction complicates LV training.
TAKE-HOME MESSAGES: Ventricular dysfunction during LV preparation warrants evaluation for reversible contributors, including pacing-associated dyssynchrony and excessive pressure loading, before abandonment of anatomic repair. Following multimodal rehabilitation, serial imaging and pressure-volume analysis can assess LV systolic recovery, diastolic reserve, and loading tolerance for systemic work.