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"double switch" procedure for congenitally corrected ...
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"double switch" procedure for congenitally corrected transposition of the great arteries.


  I am 38 years old and was diagnosed with congenitally corrected transposition
  of the great arteries about 6 years ago.  I have been advised that I may be
  a candidate for the "double switch" procedure to correct my transposition.
  I was implanted with a pacemaker about 5 years ago because of complete con-
  genital heart block.  I am basically asymptomatic although my mitral valve
  has a slight to moderate regurgitation and my tricuspid has a moderate  re-
  gurgitation. I have been told that my "ejection fraction" is 35% by echo.
  Am I a candidate for this operation?  What can someone in my situation expect?
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Dear Craig,
At present the "double switch" procedure for congenitally corrected transposition is considered highly experimental. Also at present the results are poor for the adult population (age>16yr).  As for what you can expect with this diagnosis, there will be gradual worsening of your ejection fraction over time accompanied by the onset of heart failure symptoms.  How long we are talking about is anyone's guess and is very much individualized.  
What you can do is seek regular medical follow up, evaluation, and treatment with a cardiologist and or general internal medicine physician.  There are a lot of medicines to treat heart failure; since we know that heart failure is progressive in congenitally corrected transposition, at present our only treatment for end stage disease (a completely failing heart) is heart transplant.  It is important that you not do isometric exercises rather do moderate aerobic exercise only.  Avoid strenuous activities in general but just as important is
that you take care of yourself, follow your doctor's instructions and get regular follow up.  For women with congenitally corrected transposition in the childbearing years, any pregnancy must be planned, and it is very important that she recieve care and evaluation before and during the pregnancy.  Remember that although this is a progressive disease no one can predict when the heart failure will cause you problems, in the meantime head the above advice and ask questions about your disease and any symptoms you might have as often as you feel necessary.  
Information provided in the Heart Forum is intended for general informational purposes only, any diagnosis and treatment can only be made by your physician(s).
If you would like to get a second opinion regarding your 'transposition' at The Cleveland Clinic Foundation just call 1-800-CCF-CARE and ask for one of the congenital cardiologists in pediatric cardiology department.  





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