Six-Year Outcome after Valve Replacement and Resynchronization Therapy in TGA Patient

Patients with complete transposition of the great arteries (TGA) treated by Senning procedure have a higher risk developing heart failure due to: a) additional work load systemic (morphologic right) ventricle (sRV), b) arrhythmias, mainly caused surgical implications at atria as well c) worsening tricuspid regurgitation. We present unique case female patient who developed all these complications, was successfully and able to carry out twin pregnancy. This breakthrough approach based on: 1. detecting reversibility potential myocardial systolic dysfunction in severe valvular lesion combined continuous afterload settings permanent tachyarrhythmia, 2. prevention subsequently iatrogenic ventricular function pacing. Surgical replacement valve (sTV) cardiac resynchronization device (CRT) implantation after nodal ablation resulted recovering positive remodeling sRV. The reversal further decline achieved arrhythmia control, synchronous pacing epicardial leads CRT, sTV echocardiographic monitoring during pregnancy determine right time for delivery. Two years delivery, remains NYHA Class I.