title: Late outcome of Senning and Mustard procedures for correction of transposition of the great arteries.
abstract: OBJECTIVE
  To evaluate late mortality and morbidity after an atrial switch procedure for correction of transposition of the great arteries (TGA) and to assess predictive factors for adverse outcome.
  
  
  METHODS
  Tertiary referral centre.
  
  
  METHODS
  Retrospective follow up study of 137 patients surviving hospitalisation for TGA atrial switch procedure (Mustard or Senning) in a single institution and divided into two groups (simple and complex) depending on presurgical anatomy. Several surgical and follow up factors were evaluated during 16.7 (5.6) years' follow up.
  
  
  RESULTS
  Late mortality was 5.1% (95% confidence interval 1.37% to 8.84%) with sudden death as the most common cause. No significant difference was found between Mustard and Senning procedures and between the complex and simple groups in terms of mortality. Independent predictive factors for late mortality were a history of supraventricular tachyarrhythmias and advanced New York Heart Association (NYHA) functional class during follow up. A very common finding was development of sinus node dysfunction (47.6%), which had no influence on mortality. There was little need for reintervention (5.1%) and relatively few cases of right ventricular systolic dysfunction (14.6%). During follow up, most patients (96.2%) were in NYHA functional class I-II.
  
  
  CONCLUSIONS
  Overall long term outcomes of patients with atrial repair of TGA in the present era are encouraging in terms of late mortality and quality of life. Nevertheless, better outcomes may be offered through improved diagnostic methods for right ventricular function and better management of supraventricular tachyarrhythmias.
authors.affiliation: Department of General Cardiology, Hospital Materno-Infantil Vall d'Hebron, Barcelona, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Dos
authors.forename: L
authors.initials: L
authors.lastname: Teruel
authors.forename: I J
authors.initials: IJ
authors.lastname: Ferreira
authors.forename: J
authors.initials: J
authors.lastname: Rodriguez-Larrea
authors.forename: L
authors.initials: L
authors.lastname: Miro
authors.forename: J
authors.initials: J
authors.lastname: Girona
authors.forename: D C
authors.initials: DC
authors.lastname: Albert
authors.forename: A
authors.initials: A
authors.lastname: Gonçalves
authors.forename: M
authors.initials: M
authors.lastname: Murtra
authors.forename: J
authors.initials: J
authors.lastname: Casaldaliga
mesh_terms: D000293:Adolescent; D000328:Adult; D001145:Arrhythmias, Cardiac / Q000209:etiology; D006348:Cardiac Surgical Procedures / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D016757:Death, Sudden, Cardiac / Q000209:etiology; D004452:Echocardiography / Q000379:methods; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D015999:Multivariate Analysis; D011788:Quality of Life; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014188:Transposition of Great Vessels / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*