Copyright © 2004 by the European Society of Cardiology.
Clinical research
Decline in ventricular function and clinical condition after mustard repair for transposition of the great arteries (a prospective study of 22–29 years)
a Department of Cardiology, Thoraxcenter, Erasmus MC, Dr Molewaterplein 40, 3015 GD Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
b Department of Cardiothoracic Surgery, Thoraxcenter, Erasmus MC, Dr Molewaterplein, Rotterdam, The Netherlands
c Department of Child and Adolescent Psychiatry, Erasmus MC, Dr Molewaterplein, Rotterdam, The Netherlands
* Corresponding author. Tel.: +31-1046-32432; fax: +31-1046-35498
E-mail address: j.roos{at}erasmusmc.nl
Received 11 September 2003; revised 2 February 2004; accepted 4 March 2004
Abstract
Background Great concern exists about the ability of the anatomic right ventricle to sustain the systemic circulation in patients with transposition of the great arteries who have undergone a Mustard procedure. A prospective study was made to examine long-term survival, clinical outcome, and right ventricular function 25 years after surgery.
Methods Ninety-one consecutive patients underwent the Mustard procedure between 1973 and 1980. After 14 years and again after 25 years (range 22–29 years), patients were studied with ECG, echocardiography, exercise testing, and Holter monitoring.
Results The cumulative survival and event-free survival were 77% and 36%, respectively, after 25 years. Reoperation was necessary in 46%. No major loss of sinus rhythm was found.
While all patients had good right ventricular function 14 years after repair, 61% of patients showed moderate-to-severe dysfunction after 25 years, when studied by echocardiography. Furthermore, the QRS complex widened and exercise capacity decreased.
Conclusion The anatomic right ventricle appears to be unable to sustain the systemic circulation at long-term follow-up and the clinical condition of patients late after Mustard repair is declining. We can expect more deaths or need for heart transplantation in the next decade.
Key Words: Transposition of great arteries • Congenital heart defects • Survival • Follow-up studies • Echocardiography
CiteULike 
Connotea 
Del.icio.us What's this?
Related articles in EHJ:
- Decline in ventricular function and clinical condition after Mustard repair
- Graham Derrick and John E. Deanfield
EHJ 2004 25: 1863-1864.[Extract] [Full Text]
This article has been cited by other articles:
|
|
 |
|
  A. A. Frogoudaki Assessing the Failing Systemic Right Ventricle Angiology, August 1, 2008; 59(2_suppl): 93S - 96S. [Abstract] [PDF]
|
|
|
|
 |
|
 P-C Chow, X-C Liang, E W Y Cheung, W W M Lam, and Y-F Cheung New two-dimensional global longitudinal strain and strain rate imaging for assessment of systemic right ventricular function Heart, July 1, 2008; 94(7): 855 - 859. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. J. Sommer, Z. M. Hijazi, and J. F. Rhodes Pathophysiology of Congenital Heart Disease in the Adult: Part III: Complex Congenital Heart Disease Circulation, March 11, 2008; 117(10): 1340 - 1350. [Full Text] [PDF]
|
|
|
|
|
|
C. A. Warnes Transposition of the Great Arteries Circulation, December 12, 2006; 114(24): 2699 - 2709. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S Fratz, M Hauser, F M Bengel, A Hager, H Kaemmerer, M Schwaiger, J Hess, and H C Stern Myocardial scars determined by delayed-enhancement magnetic resonance imaging and positron emission tomography are not common in right ventricles with systemic function in long-term follow up Heart, November 1, 2006; 92(11): 1673 - 1677. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P A Davlouros, K Niwa, G Webb, and M A Gatzoulis The right ventricle in congenital heart disease Heart, April 1, 2006; 92(suppl_1): i27 - i38. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Drenthen, P. G. Pieper, M. Ploeg, A. A. Voors, J. W. Roos-Hesselink, B. J.M. Mulder, H. W. Vliegen, K. M. Sollie, T. Ebels, D. J. van Veldhuisen, et al. Risk of complications during pregnancy after Senning or Mustard (atrial) repair of complete transposition of the great arteries Eur. Heart J., December 1, 2005; 26(23): 2588 - 2595. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. P. Graham Jr The Year in Congenital Heart Disease J. Am. Coll. Cardiol., June 7, 2005; 45(11): 1887 - 1899. [Full Text] [PDF]
|
|
|
|
|
|
G. Derrick and J. E. Deanfield Decline in ventricular function and clinical condition after Mustard repair Eur. Heart J., November 1, 2004; 25(21): 1863 - 1864. [Full Text] [PDF]
|
|