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J Am Coll Cardiol. 1998 Sep;32(3):758-65.

Long-term outcome after the mustard repair for simple transposition of the great arteries. 28-year follow-up.

Author information

1
Cardiology Department, Green Lane Hospital, Auckland, New Zealand. nigelw@ahsl.co.nz

Abstract

OBJECTIVES:

This study examines the late outcome in patients with simple transposition of the great arteries (TGA) after a Mustard operation.

BACKGROUND:

Continuing medical follow-up for patients after the Mustard procedure, now extending to three decades, is required. The quality of life of adult survivors has not been well documented.

METHODS:

Survival and quality of life among 113 hospital survivors of the Mustard operation performed for simple TGA between 1964 and 1982 were assessed by medical review and a lifestyle questionnaire. The incidence of right ventricular failure and echocardiographic right ventricular dysfunction (RVD) were determined. A measure of lifestyle, the ability index, was determined.

RESULTS:

Actuarial survival was 90%, 80%, and 80% at 10, 20, and 28 years, respectively, with 76% of survivors being New York Heart Association class 1. Sudden death, with an incidence of 7% without identifiable risk factors, was the most common cause of late demise. RVD was identified in 18% of patients who had echocardiography, but there was right ventricular failure in only two patients. Seventy-five percent of current survivors lead a normal life, 20% have some symptoms or lifestyle modification, and 5% are unable to work.

CONCLUSIONS:

The survival of patients to 28 years with the Mustard repair has been good. Late sudden death is the most worrisome feature. There is a 97% freedom from right ventricular failure to date. The quality of life of late survivors is good, most achieving a normal level of education and employment.

PMID:
9741524
DOI:
10.1016/s0735-1097(98)00309-x
[Indexed for MEDLINE]
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