Long-term morbidity and quality of life after surgical repair of transposition of the great arteries: atrial versus arterial switch operation

Interact Cardiovasc Thorac Surg. 2011 Apr;12(4):569-74. doi: 10.1510/icvts.2010.253898. Epub 2011 Jan 12.


Since 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.

Publication types

  • Comparative Study

MeSH terms

  • Cardiac Surgical Procedures* / adverse effects
  • Cardiac Surgical Procedures* / mortality
  • Cardiovascular Agents / therapeutic use
  • Chi-Square Distribution
  • Child, Preschool
  • Female
  • Germany
  • Heart Conduction System / physiopathology
  • Humans
  • Infant
  • Infant, Newborn
  • Kaplan-Meier Estimate
  • Male
  • Quality of Life*
  • Reoperation
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Surveys and Questionnaires
  • Survival Rate
  • Survivors
  • Time Factors
  • Transposition of Great Vessels / mortality
  • Transposition of Great Vessels / physiopathology
  • Transposition of Great Vessels / psychology
  • Transposition of Great Vessels / surgery*
  • Treatment Outcome
  • Vascular Surgical Procedures* / adverse effects
  • Vascular Surgical Procedures* / mortality
  • Ventricular Function


  • Cardiovascular Agents