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Interact Cardiovasc Thorac Surg · Apr 2011
Comparative StudyLong-term morbidity and quality of life after surgical repair of transposition of the great arteries: atrial versus arterial switch operation.
- Heidi Görler, Masamichi Ono, Arne Thies, Esther Lunkewitz, Mechthild Westhoff-Bleck, Axel Haverich, Thomas Breymann, and Dietmar Boethig.
- Division of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany. goerler.adelheid@mh-hannover.de
- Interact Cardiovasc Thorac Surg. 2011 Apr 1; 12 (4): 569-74.
AbstractSince 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.
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