Outcomes for congenitally corrected transposition of great arteries using various surgical techniques: a systematic review and network meta-analysis.
S U Hasan, Sur Usmani, S H Ahmed et al.
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In 30 seconds
This systematic review and random-effects network meta-analysis compared physiological, anatomical and Fontan repair for congenitally corrected transposition of the great arteries (ccTGA). It included 1,209 patients from nine studies identified through searches up to 5 June 2023. Fontan repair was associated with higher transplant-free survival than the other approaches; its reported absolute risk was 0.999 (±0.0101; 95% CI). Mortality and postoperative arrhythmia differences did not reach statistical significance. Fontan repair also had a better rank probability for overall survival and reintervention after definitive surgery.
Key findings
- Nine studies contributed 1,209 patients with ccTGA to the network meta-analysis.
- Fontan repair was associated with transplant-free survival at an absolute risk of 0.999 (±0.0101; 95% CI).
- Mortality and postoperative arrhythmia differences between repair approaches did not reach statistical significance.
- Fontan repair had a better rank probability for overall survival and reintervention after definitive surgery.
Why it matters
The analysis compares major surgical strategies for a rare congenital condition and suggests that outcomes may differ by repair type, particularly for transplant-free survival. These comparative estimates can inform discussion of surgical options, while the lack of statistically significant differences in mortality and arrhythmias underscores that advantages were not demonstrated across all reported outcomes.
What to keep in mind
The analysis included nine studies, and the abstract does not report study-level design or details needed to assess comparability among treatment groups.