How well are patients doing up to 30 years after a mustard operation?

Thorac Cardiovasc Surg. 2007 Sep;55(6):359-64. doi: 10.1055/s-2007-964847.

Abstract

Background: Right heart failure and baffle complications may affect the health status of patients with transposition of the great arteries after an atrial switch operation.

Methods: This study aims to identify risk factors for late death, the incidence of reoperations, and the functional status of 88 patients who underwent a Mustard operation with a mean follow-up of 20.9 +/- 10.0 years.

Results: There were 7 early and 19 late deaths. Follow-up was complete for 97 % of the hospital survivors. Survival and freedom from reoperation of the hospital survivors at 20 years was 83.7 +/- 4.2 %, and 70.6 +/- 5.4 %, respectively. Seven reoperations were performed for systemic ventricular failure, and 24 for baffle complications, with no operative mortality. Presence of a ventricular septal defect at the time of the Mustard operation was predictive for late death in multivariate analysis ( P = 0.040). At follow-up, 82 % of the patients were able to work full-time, 11 % part-time, and 7 % experienced noticeable limitations of their activities.

Conclusions: Presence of a VSD at the time of the Mustard operation defines a distinct subgroup with an increased risk for late death. Long-term survivors were in a good functional status but had to be reoperated frequently due to baffle complications that seemed to increase in adulthood.

MeSH terms

  • Aged
  • Cardiovascular Surgical Procedures / methods*
  • Echocardiography
  • Female
  • Follow-Up Studies
  • Health Status*
  • Humans
  • Male
  • Postoperative Period
  • Reoperation
  • Retrospective Studies
  • Risk Factors
  • Surveys and Questionnaires
  • Survival Rate / trends
  • Time Factors
  • Transposition of Great Vessels / diagnostic imaging
  • Transposition of Great Vessels / mortality
  • Transposition of Great Vessels / surgery*
  • Treatment Outcome