当前位置： SCI文献检索 > CIRCULATION期刊下所有文献 > Comparison of long-term outcomes of atrial repair of simple transposition with implications for a late arterial switch strategy.

Comparison of long-term outcomes of atrial repair of simple transposition with implications for a late arterial switch strategy.

Abstract：

BACKGROUND:We report the single-institution, long-term results of 358 patients with simple transposition of the great arteries surviving >30 days after a Mustard (n=226, 1965 to 1980) or Senning (n=132, 1978 to 1992) procedure. METHODS AND RESULTS:Outcome measures included late death, reintervention, ECG and ambulatory ECG rhythm, new arrhythmia, and functional status. Average follow-up was 13.4 (range 0.32 to 17.9) years for the Senning group and 11.7 (range 0.04 to 23.9) years for the Mustard group. The Senning group had a better survival rate at 5, 10, and 15 years (95% versus 86%, 94% versus 82%, and 94% versus 77%, respectively). In both groups, the majority of late deaths were sudden, without preceding ventricular dysfunction. Survival and survival free of reintervention were significantly better in the Senning group (relative risk [RR] 0.34, P=0.06 versus RR 0.39, P=0.027). Loss of sinus rhythm was comparable and unrelated to death. After era correction, the incidence of atrial flutter was similar and strongly associated with late death in both groups. Clinical systemic ventricular failure was uncommon, and at last follow-up, 92% of the Senning group and 89% of the Mustard group were in New York Heart Association class I. In a model exploring the implications of elective arterial switch conversion, this would only be beneficial if the hazard late after switch was markedly reduced and/or the hazard after the Senning procedure increased with time. CONCLUSIONS:Late outcomes after the Senning procedure are superior to those after the Mustard procedure. Both groups had late sudden deaths that were not associated with clinical systemic ventricular failure. Good functional status after the Senning procedure suggests that a strategy of elective switch conversion cannot be justified for patients with isolated transposition.

journal_name

Circulation

journal_title

Circulation

authors

Sarkar D,Bull C,Yates R,Wright D,Cullen S,Gewillig M,Clayton R,Tunstill A,Deanfield J

doi

10.1161/01.cir.100.suppl_2.ii-176

subject

Has Abstract

pub_date

1999-11-09 00:00:00

pages

II-176-81

issue

Suppl 2

eissn

0009-7322

issn

1524-4539

journal_volume

100

pub_type

杂志文章

在线工具

Comparison of long-term outcomes of atrial repair of simple transposition with implications for a late arterial switch strategy.