Cardiac Resynchronization Therapy Pacemaker and Double Valve Replacements Improved Cardiac Function after Physiological Repair in a Patient with Congenitally Corrected Transposition of the Great Arteries

The morphological right ventricle supports systemic circulation following physiological repair of congenitally corrected transposition of the great arteries (ccTGA); however, complications such as failure of the right ventricle, tricuspid valve regurgitation, and arrhythmia can arise in adolescence and adulthood. Here, we report the case of a 26-year-old woman who underwent a 4th surgery after undergoing physiological repair for ccTGA. Previously, she underwent a shunt procedure at the age of 3, ccTGA repair at the age of 10, and replacement of the left ventricle to the pulmonary artery conduit when she was 20 years old. In recent years, she was frequently hospitalized due to acute heart failure and atrial tachyarrhythmia. After further examination, we performed aortic and tricuspid valve replacement, and upgraded her cardiac resynchronization therapy pacemaker (CRT-P). Her post-operative course was uneventful, although she was administered catecholamine for an extended duration. Electrocardiogram revealed a decreased duration of QRS from 204 ms to 112 ms, following the CRT-P upgrade, and her brain natriuretic peptide level also markedly improved. She is doing well 2 years and 9 months after the surgeries.