Long-term outcome and quality of life after arterial switch operation: a prospective study with a historical comparison.

Autor: Ruys TP; Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands. p.ruys@erasmusmc.nl, van der Bosch AE, Cuypers JA, Witsenburg M, Helbing WA, Bogers AJ, van Domburg R, McGhie JS, Geleijnse ML, Henrichs J, Utens E, Van der Zwaan HB, Takkenberg JJ, Roos-Hesselink JW
Jazyk: angličtina
Zdroj: Congenital heart disease [Congenit Heart Dis] 2013 May-Jun; Vol. 8 (3), pp. 203-10. Date of Electronic Publication: 2013 Jan 28.
DOI: 10.1111/chd.12033
Abstrakt: AIM.: The study aims to describe the long-term cardiological and psychological results of our first surgical cohort of arterial switch operation (ASO) patients and compare the results with our earlier series of Mustard patients. METHODS.: Twenty-four survivors of ASO operated in our center (1985-1990) were evaluated by electrocardiography, echocardiography, magnetic resonance imaging, exercise testing, 24-hour Holter-monitoring, and health-related quality of life questionnaire. The results were compared with 58 adult Mustard patients who were evaluated in 2001 using the same study protocol. RESULTS.: Arterial switch operation was performed at a median age of 13 days and Mustard operation at 2 years. Median follow-up was 22 years (range 20-25) and 25 years (22-29), respectively. After ASO, survival was better (P =.04). The event-free survival after 22 years was 77% after ASO vs. 44% after Mustard (P =.03). Good systemic ventricular function was present in 93% after ASO vs. 6% after Mustard (P <.01). Exercise capacity in ASO was 85% of predicted, compared with 72% in Mustard patients (P =.01). Aortic regurgitation was found in 21% of ASO patients vs. 16% in Mustard patients. Arterial switch patients vs. Mustard patients reported significantly better quality of life and less somatic complaints. CONCLUSION.: The progression made in surgical treatment for transposition of the great arteries from Mustard to ASO has had a positive impact on survival, cardiac function, exercise capacity, and also self-reported quality of life and somatic complaints. Longer follow-up is warranted to monitor aortic regurgitation.
(© 2013 Wiley Periodicals, Inc.)
Databáze: MEDLINE
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