Extended follow-up after atrial repair for transposition of the great arteries: a younger age at surgery improves late survival

Details

Serval ID
serval:BIB_76085C4AA163
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Extended follow-up after atrial repair for transposition of the great arteries: a younger age at surgery improves late survival
Journal
Journal of Cardiac Surgery
Author(s)
Genoni  M., Vogt  P., von Segesser  L., Seifert  B., Arbenz  U., Jenni  R., Turina  M.
ISSN
0886-0440
Publication state
Published
Issued date
08/1999
Peer-reviewed
Oui
Volume
14
Number
4
Pages
246-51
Notes
Journal Article --- Old month value: Jul-Aug
Abstract
BACKGROUND: Surgical treatment for transposition of the great arteries (TGA) usually involves anatomic repair, although atrial repair is used in cases with special coronary artery patterns. METHODS: Records of all 239 patients surviving at least 30 days after atrial correction of TGA between 1962 and 1987 at the University Hospital in Zurich were reviewed. The mean length of follow-up time was 13.7 years (median 14.9 years; range from 0.05 to 30.1 years). The average age at surgery was 45.7 months (range from 7 days to 24.4 years). One hundred twenty-one patients had a simple TGA, whereas the remaining 118 had a complex TGA. RESULTS: The surviving patients were in NYHA class I at time of follow-up. The most common reasons for death were systemic right ventricular dysfunction and sudden rhythm disturbances. There was a major risk for late cardiac event in patients over 3 years old at operation (p = 0.02) and also in patients with complex TGA (p = 0.03). However, date of surgery, previous surgery, or the postoperative requirement for a pacemaker did not greatly affect late cardiac mortality. CONCLUSIONS: Although the procedure of choice for TGA is the arterial switch operation, the promising findings of the current long-term study, which reports the longest follow-up to date, indicate that the atrial switch operation is a good alternative procedure for the rare cases where the use of arterial switch procedures is limited.
Keywords
Adolescent Age Factors *Cardiac Surgical Procedures Child Child, Preschool Follow-Up Studies Heart Atria/surgery Humans Infant Infant, Newborn Retrospective Studies Risk Factors Survival Analysis Transposition of Great Vessels/*mortality/*surgery
Pubmed
Web of science
Create date
14/02/2008 15:19
Last modification date
20/08/2019 15:33
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