title: Long-term morbidity and quality of life after surgical repair of transposition of the great arteries: atrial versus arterial switch operation.
abstract: Since a growing number of patients after surgical repair of transposition of the great arteries (TGA) survive until adulthood the focus of attention has shifted to the management of associated long-term morbidity and quality of life (QoL). Therefore, we reviewed all patients that underwent surgical repair of TGA at our institution and compared long-term results after atrial and arterial switch operation. Between 1973 and 2000, a total of 302 patients underwent either atrial switch operation (n=222) or arterial switch operation (n=80). Mean follow-up was 14.5±10.1 years. The arterial switch repair was associated with a higher early mortality whereas long-term survival was comparable between both groups. Postoperative arrhythmias including loss of sinus rhythm and pacemaker implantation occurred significantly more often after atrial switch repair. There was a trend towards a more favourable outcome of the arterial switch group concerning freedom from re-interventions, severe systemic ventricular dysfunction and need for heart failure medication. However, also the arterial switch operation was associated with an increased incidence of loss of sinus rhythm and neo-aortic valve regurgitation during late follow-up. Health related QoL according to the SF-36 questionnaire was not significantly different between both groups and comparable to a healthy population.
authors.affiliation: Division of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany. goerler.adelheid@mh-hannover.de
authors.forename: Heidi
authors.initials: H
authors.lastname: Görler
authors.forename: Masamichi
authors.initials: M
authors.lastname: Ono
authors.forename: Arne
authors.initials: A
authors.lastname: Thies
authors.forename: Esther
authors.initials: E
authors.lastname: Lunkewitz
authors.forename: Mechthild
authors.initials: M
authors.lastname: Westhoff-Bleck
authors.forename: Axel
authors.initials: A
authors.lastname: Haverich
authors.forename: Thomas
authors.initials: T
authors.lastname: Breymann
authors.forename: Dietmar
authors.initials: D
authors.lastname: Boethig
mesh_terms: D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D002317:Cardiovascular Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D002675:Child, Preschool; D005260:Female; D005858:Germany; D006329:Heart Conduction System / Q000503:physiopathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D008297:Male; D011788:Quality of Life; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D015996:Survival Rate; D017741:Survivors; D013997:Time Factors; D014188:Transposition of Great Vessels / Q000401:mortality / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D016276:Ventricular Function
chemical_list: D002317:Cardiovascular Agents