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Thorac Cardiovasc Surg 2007; 55(6): 359-364
DOI: 10.1055/s-2007-964847
Original Cardiovascular

© Georg Thieme Verlag KG Stuttgart · New York

How Well Are Patients Doing Up to 30 Years after a Mustard Operation?

J. Hörer1 , F. Herrmann1 , C. Schreiber1 , J. Cleuziou1 , Z. Prodan1 , M. Vogt2 , K. Holper1 , R. Lange1
  • 1Department of Cardiovascular Surgery, German Heart Center Munich at the Technical University, Munich, Germany
  • 2Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich at the Technical University, Munich, Germany
Further Information

Publication History

received October 12, 2006

Publication Date:
24 August 2007 (online)

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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.

Key words

adult - heart defects - congenital - follow‐up studies - surgery - transposition of great arteries - risk factors

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Dr. Jürgen Hörer

Department of Cardiovascular Surgery
German Heart Center Munich at the Technical University

Lazarettstraße 36

80636 Munich

Germany

Phone: + 49 89 12 18 41 11

Fax: + 49 89 12 18 41 23

Email: hoerer@dhm.mhn.de