title: Long-Term Outcome of Mustard/Senning Correction for Transposition of the Great Arteries in Sweden and Denmark.
abstract: BACKGROUND
  The atrial switch operation, the Mustard or Senning operation, for the transposition of the great arteries (TGA) was introduced in the late 1950s and was the preferred surgery for TGA until the early 1990s. The Mustard and Senning operation involves extensive surgery in the atria and leaves the right ventricle as the systemic ventricle. The Mustard and Senning cohort is now well into adulthood and we begin to see the long-term outcome.
  
  
  RESULTS
  All the 6 surgical centers that performed Mustard and Senning operations in Sweden and Denmark identified all operated TGA patients. Information about death was obtained in late 2007 and early 2008 from the Danish and Swedish Centralised Civil Register by using the patients' unique national Civil Registration Numbers. Four hundred sixty-eight patients undergoing the atrial switch operation were identified. Perioperative 30-day mortality was 20%, and 60% were alive after 30 years of follow-up. Perioperative mortality was significantly increased by the presence of a ventricular septal defect, left ventricular outflow obstruction, surgery early in the Mustard and Senning era. However, only pacemaker implantation is predictive of long-term outcome (hazard ratio, 1.90; 95% confidence interval, 1.05-3.46, P=0.04), once the TGA patient has survived the perioperative period. The risk of reoperation was correlated to the presence of associated defects and where the first Mustard/Senning operation was performed.
  
  
  CONCLUSIONS
  The long-term survival of patients with Mustard and Senning correction for TGA appears to be primarily determined by factors in the right ventricle and tricuspid valve and not the timing of or the type of surgery in childhood. Cardiac function necessitating the implantation of a pacemaker is associated with an increase in mortality.
authors.affiliation: From Department of Cardiology, Rigshospitalet, Copenhagen, Denmark (N.V., L.S.); Skejby Hospital, Aarhus, Denmark (K.S.); Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden (E.M.); Department of Cardiology, Skåne University Hospital, Lund University, Sweden (U.T.); Department of Cardiology, University Hospital of Uppsala, Sweden (P.K.); Department of Public Health and Clinical Medicine, Umeå University, Sweden (B.J.); GUCH Center Göteborg, Department of Cardiology, Herlev County Hospital, Denmark (K.I.); and Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Göteborg, Sweden (M.D., P.E.). niels.vejlstrup@regionh.dk.
authors.forename: Niels
authors.initials: N
authors.lastname: Vejlstrup
authors.affiliation: From Department of Cardiology, Rigshospitalet, Copenhagen, Denmark (N.V., L.S.); Skejby Hospital, Aarhus, Denmark (K.S.); Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden (E.M.); Department of Cardiology, Skåne University Hospital, Lund University, Sweden (U.T.); Department of Cardiology, University Hospital of Uppsala, Sweden (P.K.); Department of Public Health and Clinical Medicine, Umeå University, Sweden (B.J.); GUCH Center Göteborg, Department of Cardiology, Herlev County Hospital, Denmark (K.I.); and Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Göteborg, Sweden (M.D., P.E.).
authors.forename: Keld
authors.initials: K
authors.lastname: Sørensen
authors.affiliation: From Department of Cardiology, Rigshospitalet, Copenhagen, Denmark (N.V., L.S.); Skejby Hospital, Aarhus, Denmark (K.S.); Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden (E.M.); Department of Cardiology, Skåne University Hospital, Lund University, Sweden (U.T.); Department of Cardiology, University Hospital of Uppsala, Sweden (P.K.); Department of Public Health and Clinical Medicine, Umeå University, Sweden (B.J.); GUCH Center Göteborg, Department of Cardiology, Herlev County Hospital, Denmark (K.I.); and Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Göteborg, Sweden (M.D., P.E.).
authors.forename: Eva
authors.initials: E
authors.lastname: Mattsson
authors.affiliation: From Department of Cardiology, Rigshospitalet, Copenhagen, Denmark (N.V., L.S.); Skejby Hospital, Aarhus, Denmark (K.S.); Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden (E.M.); Department of Cardiology, Skåne University Hospital, Lund University, Sweden (U.T.); Department of Cardiology, University Hospital of Uppsala, Sweden (P.K.); Department of Public Health and Clinical Medicine, Umeå University, Sweden (B.J.); GUCH Center Göteborg, Department of Cardiology, Herlev County Hospital, Denmark (K.I.); and Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Göteborg, Sweden (M.D., P.E.).
authors.forename: Ulf
authors.initials: U
authors.lastname: Thilén
authors.affiliation: From Department of Cardiology, Rigshospitalet, Copenhagen, Denmark (N.V., L.S.); Skejby Hospital, Aarhus, Denmark (K.S.); Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden (E.M.); Department of Cardiology, Skåne University Hospital, Lund University, Sweden (U.T.); Department of Cardiology, University Hospital of Uppsala, Sweden (P.K.); Department of Public Health and Clinical Medicine, Umeå University, Sweden (B.J.); GUCH Center Göteborg, Department of Cardiology, Herlev County Hospital, Denmark (K.I.); and Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Göteborg, Sweden (M.D., P.E.).
authors.forename: Per
authors.initials: P
authors.lastname: Kvidal
authors.affiliation: From Department of Cardiology, Rigshospitalet, Copenhagen, Denmark (N.V., L.S.); Skejby Hospital, Aarhus, Denmark (K.S.); Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden (E.M.); Department of Cardiology, Skåne University Hospital, Lund University, Sweden (U.T.); Department of Cardiology, University Hospital of Uppsala, Sweden (P.K.); Department of Public Health and Clinical Medicine, Umeå University, Sweden (B.J.); GUCH Center Göteborg, Department of Cardiology, Herlev County Hospital, Denmark (K.I.); and Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Göteborg, Sweden (M.D., P.E.).
authors.forename: Bengt
authors.initials: B
authors.lastname: Johansson
authors.affiliation: From Department of Cardiology, Rigshospitalet, Copenhagen, Denmark (N.V., L.S.); Skejby Hospital, Aarhus, Denmark (K.S.); Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden (E.M.); Department of Cardiology, Skåne University Hospital, Lund University, Sweden (U.T.); Department of Cardiology, University Hospital of Uppsala, Sweden (P.K.); Department of Public Health and Clinical Medicine, Umeå University, Sweden (B.J.); GUCH Center Göteborg, Department of Cardiology, Herlev County Hospital, Denmark (K.I.); and Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Göteborg, Sweden (M.D., P.E.).
authors.forename: Kasper
authors.initials: K
authors.lastname: Iversen
authors.affiliation: From Department of Cardiology, Rigshospitalet, Copenhagen, Denmark (N.V., L.S.); Skejby Hospital, Aarhus, Denmark (K.S.); Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden (E.M.); Department of Cardiology, Skåne University Hospital, Lund University, Sweden (U.T.); Department of Cardiology, University Hospital of Uppsala, Sweden (P.K.); Department of Public Health and Clinical Medicine, Umeå University, Sweden (B.J.); GUCH Center Göteborg, Department of Cardiology, Herlev County Hospital, Denmark (K.I.); and Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Göteborg, Sweden (M.D., P.E.).
authors.forename: Lars
authors.initials: L
authors.lastname: Søndergaard
authors.affiliation: From Department of Cardiology, Rigshospitalet, Copenhagen, Denmark (N.V., L.S.); Skejby Hospital, Aarhus, Denmark (K.S.); Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden (E.M.); Department of Cardiology, Skåne University Hospital, Lund University, Sweden (U.T.); Department of Cardiology, University Hospital of Uppsala, Sweden (P.K.); Department of Public Health and Clinical Medicine, Umeå University, Sweden (B.J.); GUCH Center Göteborg, Department of Cardiology, Herlev County Hospital, Denmark (K.I.); and Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Göteborg, Sweden (M.D., P.E.).
authors.forename: Mikael
authors.initials: M
authors.lastname: Dellborg
authors.affiliation: From Department of Cardiology, Rigshospitalet, Copenhagen, Denmark (N.V., L.S.); Skejby Hospital, Aarhus, Denmark (K.S.); Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden (E.M.); Department of Cardiology, Skåne University Hospital, Lund University, Sweden (U.T.); Department of Cardiology, University Hospital of Uppsala, Sweden (P.K.); Department of Public Health and Clinical Medicine, Umeå University, Sweden (B.J.); GUCH Center Göteborg, Department of Cardiology, Herlev County Hospital, Denmark (K.I.); and Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Göteborg, Sweden (M.D., P.E.).
authors.forename: Peter
authors.initials: P
authors.lastname: Eriksson
mesh_terms: D006348:Cardiac Surgical Procedures / Q000379:methods* / Q000401:mortality; D002675:Child, Preschool; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D015996:Survival Rate / Q000639:trends; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D014188:Transposition of Great Vessels / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome
keywords: heart defects, congenital; pacemaker, artificial; population; prognosis; survival; transposition of great vessels