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

IF 2 4区医学 Q3 SURGERY

Annals of the Royal College of Surgeons of England Pub Date : 2026-09-01 Epub Date: 2026-03-05 DOI:10.1308/rcsann.2026.0019

S U Hasan, Sur Usmani, S H Ahmed, A Pervez, M A Kamalia, A D Shah, M M Zubair

{"title":"Outcomes for congenitally corrected transposition of great arteries using various surgical techniques: a systematic review and network meta-analysis.","authors":"S U Hasan, Sur Usmani, S H Ahmed, A Pervez, M A Kamalia, A D Shah, M M Zubair","doi":"10.1308/rcsann.2026.0019","DOIUrl":null,"url":null,"abstract":"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.","PeriodicalId":8088,"journal":{"name":"Annals of the Royal College of Surgeons of England","volume":" ","pages":"510-517"},"PeriodicalIF":2.0000,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529390/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of the Royal College of Surgeons of England","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1308/rcsann.2026.0019","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/3/5 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

Abstract

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.

查看原文本刊更多论文

不同手术技术治疗先天性大动脉转位的结果：系统回顾和网络荟萃分析。

前言：先天性纠正性大动脉转位（ccTGA）是一种罕见的疾病。在这里，我们评估了生理、解剖和Fontan修复技术对ccTGA的有效性。方法：系统检索PubMed、Embase和Cochrane Central Register of Controlled Trials数据库，检索时间为2023年6月5日。进行随机效应网络meta分析，比较进行生理、解剖和Fontan修复的患者的死亡率、术后心律失常、最终手术后再干预和无移植生存。结果：9项研究共纳入1209例患者。Fontan修复与更高的无移植生存率（绝对风险[AR] 0.999（±0.0101），95%可信区间[CI]）和最终手术后再干预率（AR 0.098（±0.067），95% CI）相关，而死亡率和术后心律不整差异无统计学意义。结论：Fontan修复术在无移植生存方面明显优于解剖或生理修复术，在最终手术后总生存和再干预方面也有更好的排名概率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Annals of the Royal College of Surgeons of England Medicine-Surgery

CiteScore

2.40

自引率

0.00%

发文量

316

期刊介绍： The Annals of The Royal College of Surgeons of England is the official scholarly research journal of the Royal College of Surgeons and is published eight times a year in January, February, March, April, May, July, September and November. The main aim of the journal is to publish high-quality, peer-reviewed papers that relate to all branches of surgery. The Annals also includes letters and comments, a regular technical section, controversial topics, CORESS feedback and book reviews. The editorial board is composed of experts from all the surgical specialties.