Long-term outcome after the mustard repair for simple transposition of the great arteries. 28-year follow-up

J Am Coll Cardiol. 1998 Sep;32(3):758-65. doi: 10.1016/s0735-1097(98)00309-x.


Objectives: This study examines the late outcome in patients with simple transposition of the great arteries (TGA) after a Mustard operation.

Background: Continuing medical follow-up for patients after the Mustard procedure, now extending to three decades, is required. The quality of life of adult survivors has not been well documented.

Methods: Survival and quality of life among 113 hospital survivors of the Mustard operation performed for simple TGA between 1964 and 1982 were assessed by medical review and a lifestyle questionnaire. The incidence of right ventricular failure and echocardiographic right ventricular dysfunction (RVD) were determined. A measure of lifestyle, the ability index, was determined.

Results: Actuarial survival was 90%, 80%, and 80% at 10, 20, and 28 years, respectively, with 76% of survivors being New York Heart Association class 1. Sudden death, with an incidence of 7% without identifiable risk factors, was the most common cause of late demise. RVD was identified in 18% of patients who had echocardiography, but there was right ventricular failure in only two patients. Seventy-five percent of current survivors lead a normal life, 20% have some symptoms or lifestyle modification, and 5% are unable to work.

Conclusions: The survival of patients to 28 years with the Mustard repair has been good. Late sudden death is the most worrisome feature. There is a 97% freedom from right ventricular failure to date. The quality of life of late survivors is good, most achieving a normal level of education and employment.

MeSH terms

  • Activities of Daily Living / classification
  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Disability Evaluation
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Postoperative Complications / mortality*
  • Postoperative Complications / surgery
  • Quality of Life
  • Reoperation
  • Survival Rate
  • Transposition of Great Vessels / mortality
  • Transposition of Great Vessels / surgery*