Outcomes of transposition of the great arteries in the era of atrial inflow correction. Issue 2 (1st August 1998)

• Record Type: Journal Article
• Authors: Birnie, D; Tometzki, A; Curzio, J; Houston, A; Hood, S; Swan, L; Doig, W; Wilson, N; Jamieson, M; Pollock, J; Hillis, W S
• Is Part Of: Heart. Volume 80:Issue 2(1998)
• Page Start: 170
• Page End: 173
• Publication Date: 1998-08-01
• Subjects: transposition of the great arteries -- congenital heart disease -- Mustard operation -- Senning operation; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/hrt.80.2.170
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Objective: To examine long term morbidity and mortality following atrial inflow corrective procedures for transposition of the great arteries (TGA) and to investigate factors that influence morbidity and mortality. Design: Retrospective cohort study from a single centre. Setting: Cardiology and cardiothoracic surgical unit in a large tertiary referral centre. Patients: All 130 patients who had TGA diagnosed between August 1972 and May 1988 and were considered suitable for atrial inflow correction; 109 of these underwent surgery (operative cohort: 84 Mustard operations and 25 Senning operations); 95 survived to hospital discharge (hospital surviving cohort). Main outcome measures: Death and cardiac events. Results: There were relatively good long term results from atrial inflow correction for TGA with 5, 10, and 15 year survivals of 77.3%, 75.9%, and 71.3%. However, there was an appreciable incidence of late cardiac death and events, with 5, 10, and 15 year cardiac event-free survivals of 74.5%, 67.1%, and 39.6%. Supraventricular tachycardia was the only significant risk factor for late cardiac death (relative risk 8.72, 95% confidence interval, 2.86 to 26.64). Senning patients had better event-free survival (p = 0.04). Conclusions: Atrial inflow correction for TGA has a reasonably good 15 year survival (71.3%), but there is an appreciable incidence of late cardiac deaths and events (15 year event-free survival 39.6%). The Senning procedure is preferable to the Mustard procedure for cases unsuitable for arterial switching.