Document Detail


40 years after the first atrial switch procedure in patients with transposition of the great arteries: long-term results in Toronto and Zurich.
MedLine Citation:
PMID:  11005599     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The atrial switch procedure dramatically improved the prognosis of children with complete transposition of the great arteries (TGA). Overall actuarial survival was approximately 75% after 25 years and was better in patients with simple TGA than in those with complex TGA. Mortality by any cause (16%) and cardiovascular mortality (12% and 13%) were comparable in both centers. Progressive congestive heart failure and sudden death were the principal modes of death. Most of the survivors denied any symptoms or had mild limitations in their daily activities. However, long-term problems in this growing population of adults are challenging and include late arrhythmias (up to two thirds of the patients), systemic ventricular (SV) failure, systemic atrioventricular valve regurgitation and reoperations, such as baffle reconstruction, being the most frequent. Objective assessment of SV function obtained by echocardiography is difficult. It may include fractional area change and tricuspid annular motion. Survivors after an atrial switch procedure are unique and have a good quality of life. However, the definitive and true history of the RV supporting the systemic circulation is not as yet known.
Authors:
E Oechslin; R Jenni
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Thoracic and cardiovascular surgeon     Volume:  48     ISSN:  0171-6425     ISO Abbreviation:  Thorac Cardiovasc Surg     Publication Date:  2000 Aug 
Date Detail:
Created Date:  2001-01-03     Completed Date:  2001-01-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7903387     Medline TA:  Thorac Cardiovasc Surg     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  233-7     Citation Subset:  IM    
Affiliation:
Division of Cardiology, University Hospital, Zurich, Switzerland. erwin.oechslin@dim.usz.ch
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living
Actuarial Analysis
Adolescent
Adult
Analysis of Variance
Arrhythmias, Cardiac / etiology
Cause of Death
Death, Sudden, Cardiac / epidemiology,  etiology
Echocardiography
Follow-Up Studies
Heart Failure / etiology,  mortality
Humans
Ontario / epidemiology
Proportional Hazards Models
Quality of Life
Reoperation / statistics & numerical data
Severity of Illness Index
Survival Analysis
Switzerland / epidemiology
Time Factors
Transposition of Great Vessels / complications,  mortality,  psychology,  surgery*
Treatment Outcome
Ventricular Dysfunction, Right / etiology,  mortality

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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