Transposition of the great arteries in western Sweden 1964-83. Incidence, survival, complications and modes of death.
The records of all children with simple (n = 73) and complex (n = 35) transposition of the great arteries who were born in western Sweden during 1964-83 were studied. The incidence was 0.24/1000 births. The preoperative mortality decreased from 100%, in 1964, before palliation was introduced, to 16% at the end of the study period. Sixty-six underwent corrective procedures: 37 Mustard, 21 Senning, 3 arterial switch and 5 Rastelli operations. The perioperative mortality, which was 26% in simple transposition and 75% in complex, did not decrease significantly during the study period. Of 39 hospital survivors, eight Mustard and two Senning patients died late of baffle complications (n = 2), sudden death (n = 6), pulmonary vascular disease (n = 1) and systemic ventricle dysfunction (n = 1). The cumulative 20-year survival was 32% in simple transposition and 17% in complex. In a pioneer population with transposition, long-term survival was unsatisfactory. This was caused by continuing high perioperative mortality and late deaths.
Gilljam
T
T
Department of Pediatrics, East Hospital, Göteborg, Sweden.
D000293:Adolescent; D000328:Adult; D006348:Cardiac Surgical Procedures / Q000379:methods / Q000401:mortality / Q000639:trends; D002423:Cause of Death / Q000639:trends; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013548:Sweden / Q000453:epidemiology; D014188:Transposition of Great Vessels / Q000453:epidemiology / Q000401:mortality* / Q000601:surgery