title: Long-term psychosocial outcome of adults with tetralogy of Fallot and transposition of the great arteries: a historical comparison.
abstract: OBJECTIVE
  To make a historical comparison on the long-term psychosocial outcome of cardiothoracic surgery during childhood.
  
  
  METHODS
  Adult patients operated for tetralogy of Fallot or transposition of the great arteries between 1980 and 1990 (recent sample) were compared with patients who underwent surgery and were investigated 10 years earlier (historical sample). In addition, atrial switch and arterial switch patients within the recent sample were compared. Psychosocial functioning was measured using standardised, validated psychological questionnaires.
  
  
  RESULTS
  Although the recent sample of patients overall shows a favourable quality of life, impairments were found in income, living conditions, relationships, offspring, and occupational level. Compared with the historical sample, the recent sample showed no significant improvements on psychosocial functioning, except for a better educational level. The amount of educational problems, such as learning difficulties, was still high compared with normative data. Recently operated patients with transposition of the great arteries (arterial switch) scored significantly better on the Short Form-36 vitality scale (p = 0.02) compared with historical patients with transposition of the great arteries (atrial switch).
  
  
  CONCLUSIONS
  Despite improvements in medical treatment over the past few decades, hardly any change was found in the psychosocial outcome of the recent patient sample compared with the historical patient sample. In particular, the percentage of patients needing special education and showing learning problems remained high, whereas income was low compared with normative data.
authors.affiliation: 1Department of Cardiology,Thoraxcenter,Erasmus Medical Center,Rotterdam,The Netherlands.
authors.forename: Petra
authors.initials: P
authors.lastname: Opić
authors.affiliation: 2Department of Child and Adolescent Psychiatry/Psychology,Erasmus Medical Center-Sophia Children's Hospital,Rotterdam,The Netherlands.
authors.forename: Elisabeth M W J
authors.initials: EM
authors.lastname: Utens
authors.affiliation: 1Department of Cardiology,Thoraxcenter,Erasmus Medical Center,Rotterdam,The Netherlands.
authors.forename: Titia P E
authors.initials: TP
authors.lastname: Ruys
authors.affiliation: 1Department of Cardiology,Thoraxcenter,Erasmus Medical Center,Rotterdam,The Netherlands.
authors.forename: Ron T
authors.initials: RT
authors.lastname: van Domburg
authors.affiliation: 1Department of Cardiology,Thoraxcenter,Erasmus Medical Center,Rotterdam,The Netherlands.
authors.forename: Maarten
authors.initials: M
authors.lastname: Witsenburg
authors.affiliation: 3Department of Cardiothoracic Surgery,Erasmus Medical Center,Rotterdam,The Netherlands.
authors.forename: Ad J J C
authors.initials: AJ
authors.lastname: Bogers
authors.affiliation: 1Department of Cardiology,Thoraxcenter,Erasmus Medical Center,Rotterdam,The Netherlands.
authors.forename: Jolien W
authors.initials: JW
authors.lastname: Roos-Hesselink
mesh_terms: D000328:Adult; D006348:Cardiac Surgical Procedures / Q000523:psychology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007859:Learning Disabilities / Q000523:psychology; D008297:Male; D011788:Quality of Life / Q000523:psychology*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013771:Tetralogy of Fallot / Q000523:psychology* / Q000601:surgery; D014188:Transposition of Great Vessels / Q000523:psychology* / Q000601:surgery; D055815:Young Adult