{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T08:07:23Z","timestamp":1787386043358,"version":"build-2736575974"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The optimal surgical strategy for congenitally corrected transposition of the great arteries (ccTGA) remains debated. This study aimed to compare the long-term outcomes of each surgical approach and to explore the optimal management strategy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed 107 consecutive patients with ccTGA who underwent biventricular repair at our institution between 1978 and 2023. Patients were categorized into 4 groups: atrial switch with arterial switch (AR-A, n\u2009=\u200917), atrial switch with Rastelli (AR-R, n\u2009=\u200959), physiological repair with Rastelli (PR-R, n\u2009=\u200917), and physiological repair with a native pulmonary valve (PR-N, n\u2009=\u200914). The primary end-point was all-cause mortality. Secondary end-points included reoperation, heart failure, arrhythmia, and pacemaker implantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median follow-up was 16 years (IQR, 5.2-25). Twenty-year survival did not differ between anatomical and physiological repair (79% vs 82%, P\u2009=\u2009.97). Among the 4 groups, survival was 94% (AR-A), 75% (AR-R), 86% (PR-R), and 77% (PR-N). Reoperation-free survival was lowest in PR-R (29%) and significantly lower in Rastelli-type repairs (P\u2009=\u2009.009). Heart failure occurred more often in Rastelli groups. AR-A achieved the most favourable functional outcomes, with preserved systemic ventricular function, the highest maximum oxygen uptake (37 mL\/kg\/minute), and the lowest brain natriuretic peptide (13 pg\/mL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this 40-year experience, survival after physiological repair was comparable to anatomical repair. However, AR-A yielded the most favourable long-term functional outcomes and should be considered the preferred strategy when anatomically feasible. Rastelli-type repairs were associated with increased reoperation and heart failure, underscoring the need for refinement of systemic ventricle outflow tract reconstruction techniques.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejcts\/ezag125","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T12:36:29Z","timestamp":1773146189000},"source":"Crossref","is-referenced-by-count":1,"title":["Comparative Long-Term Outcomes of Anatomical and Physiological Repair for Corrected Transposition"],"prefix":"10.1093","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3832-4919","authenticated-orcid":false,"given":"Yuji","family":"Tominaga","sequence":"first","affiliation":[{"name":"Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Center , Osaka, 565-8565,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Takeshita","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Center , Osaka, 565-8565,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuji","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Center , Osaka, 565-8565,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisuke","family":"Shibagaki","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Center , Osaka, 565-8565,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaya","family":"Nakamizo","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Center , Osaka, 565-8565,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenichi","family":"Kurosaki","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine , Osaka, 565-8565,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isao","family":"Shiraishi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine , Osaka, 565-8565,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigemitsu","family":"Iwai","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Center , Osaka, 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