{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T09:32:53Z","timestamp":1791192773599,"version":"4.1.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[1998,9,8]]},"abstract":"<jats:p>\n            <jats:italic>Background<\/jats:italic>\n            \u2014The outcome of patients with corrected transposition of the great arteries (CTGA) is variably affected by associated intracardiac defects, tricuspid valve competence, and systemic right ventricular (RV) function. The relative importance of these factors in long-term outcome has not been evaluated.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods and Results<\/jats:italic>\n            \u2014Since 1958, 40 patients with CTGA were studied to determine risk factors for poor outcome, including age, open heart surgery, tricuspid insufficiency (TI), cardiac rhythm, pulmonary overcirculation, and RV dysfunction. Follow-up ranged from 7 to 36 years (mean 20 years). Intracardiac repair was performed in 21 patients; 19 were unoperated or had closed heart procedures. For the purposes of this study the designation TI\n            <jats:sub>s<\/jats:sub>\n            refers to at least moderately severe TI as delineated by echocardiogram and\/or angiography. TI\n            <jats:sub>s<\/jats:sub>\n            was the only independently significant factor for death (\n            <jats:italic>P<\/jats:italic>\n            =0.01), and in turn, only the presence of a morphologically abnormal TV predicted TI\n            <jats:sub>s<\/jats:sub>\n            (\n            <jats:italic>P<\/jats:italic>\n            =0.03). Twenty-year survival without TI\n            <jats:sub>s<\/jats:sub>\n            was 93%, but only 49% with TI\n            <jats:sub>s<\/jats:sub>\n            . Poor long-term postoperative outcome was due to TI\n            <jats:sub>s<\/jats:sub>\n            in all but 1 patient; 20-year survival rates for operated patients with and without TI\n            <jats:sub>s<\/jats:sub>\n            were 34% and 90%, respectively (\n            <jats:italic>P<\/jats:italic>\n            =0.002). Similarly, 20-year survival rates for unoperated patients with and without TI\n            <jats:sub>s<\/jats:sub>\n            were 60% and 100%, respectively, whether or not attempts to repair the TI were made (\n            <jats:italic>P<\/jats:italic>\n            =0.08).\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            \u2014TI\n            <jats:sub>s<\/jats:sub>\n            represents the major risk factor for CTGA patients; RV dysfunction appears to be almost always secondary to long-standing TI. Decisions related to surgical interventions with or without associated lesions must be strongly influenced by the status of the tricuspid valve.\n          <\/jats:p>","DOI":"10.1161\/01.cir.98.10.997","type":"journal-article","created":{"date-parts":[[2012,6,12]],"date-time":"2012-06-12T00:41:02Z","timestamp":1339461662000},"page":"997-1005","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":235,"title":["Progressive Tricuspid Valve Disease in Patients With Congenitally Corrected Transposition of the Great Arteries"],"prefix":"10.1161","volume":"98","author":[{"given":"Lourdes R.","family":"Prieto","sequence":"first","affiliation":[{"name":"From the Division of Pediatric Cardiology, Department of Pediatrics, College of Physicians and Surgeons of Columbia University, New York, NY (L.R.P., A.J.H., M.S.R., W.M.G.), and the Department of Biostatistics and Epidemiology, Cleveland Clinic Foundation, Cleveland, Ohio (M.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan J.","family":"Hordof","sequence":"additional","affiliation":[{"name":"From the Division of Pediatric Cardiology, Department of Pediatrics, College of Physicians and Surgeons of Columbia University, New York, NY (L.R.P., A.J.H., M.S.R., W.M.G.), and the Department of Biostatistics and Epidemiology, Cleveland Clinic Foundation, Cleveland, Ohio (M.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Secic","sequence":"additional","affiliation":[{"name":"From the Division of Pediatric Cardiology, Department of Pediatrics, College of Physicians and Surgeons of Columbia University, New York, NY (L.R.P., A.J.H., M.S.R., W.M.G.), and the Department of Biostatistics and Epidemiology, Cleveland Clinic Foundation, Cleveland, Ohio (M.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlon S.","family":"Rosenbaum","sequence":"additional","affiliation":[{"name":"From the Division of Pediatric Cardiology, Department of Pediatrics, College of Physicians and Surgeons of Columbia University, New York, NY (L.R.P., A.J.H., M.S.R., W.M.G.), and the Department of Biostatistics and Epidemiology, Cleveland Clinic Foundation, Cleveland, Ohio (M.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Welton M.","family":"Gersony","sequence":"additional","affiliation":[{"name":"From the Division of Pediatric Cardiology, Department of Pediatrics, College of Physicians and Surgeons of Columbia University, New York, NY (L.R.P., A.J.H., M.S.R., W.M.G.), and the Department of Biostatistics and Epidemiology, Cleveland Clinic Foundation, Cleveland, Ohio (M.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_1_2","first-page":"910","volume":"38","year":"1979","unstructured":"Allwork SP, Bentall HH, Becker AE, Cameron H, Gerlis LM, Wilkinson JL, Anderson RH. Congenitally corrected transposition of the great arteries: morphologic study of 32 cases. Am J Cardiol. 1979;38:910\u2013923.","journal-title":"Am J Cardiol"},{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)38539-3"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(90)90978-A"},{"key":"e_1_3_1_4_2","first-page":"167","volume":"91","year":"1971","unstructured":"Becker AE, Becker MJ, Edwards JE. Pathologic spectrum of dysplasia of the tricuspid valve: features in common with Ebstein\u2019s malformation. Arch Pathol. 1971;91:167\u2013178.","journal-title":"Arch Pathol"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1976.tb16529.x"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(82)91234-6"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.50.5.476"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.54.1.1277415"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(10)61343-4"},{"key":"e_1_3_1_10_2","unstructured":"Grossman W. Profiles in valvular heart disease. In: Grossman W Baim DS eds. Cardiac Catheterization Angiography and Interventions. 4th ed. Philadelphia Pa: Lea & Febiger; 1991:557\u2013581."},{"key":"e_1_3_1_11_2","unstructured":"Mullins CE. In: Garson A Bricker JT McNamara D eds. Ventricular Inversion: The Science and Practice of Pediatric Cardiology. Vol 2. 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