Author + information
- Claudia Junge,
- Stephan Schoof,
- Mechtild Westhoff-Bleck,
- Reiner Buchhorn,
- Gerhard Ziemer,
- Siegfried Geyer and
- Kambiz Norozi
Two decades after surgery for transposition of the great arteries (TGA), the clinical status, cardiac function, cardiorespiratory performance and neurohormonal activity of patients who underwent either atrial switch (Mustard) or arterial switch operation (ASO) were compared. Although cardiac outcomes of patients with TGA after Mustard or ASO have been well described, long term follow up and comparison of these surgical procedures in the adult population is lacking.
Sixty-two patients with simple TGA, who underwent either Mustard (thirty-four) or ASO (twenty-eight) procedure, have been included. Following the same study protocol, a clinical work up including echocardiography, stress test and blood work was completed for all patients.
Mean age in both groups was comparable: ASO vs. Mustard [20.6 (SD=2.1) vs. 20.6 (SD=3.4) years]. All ASO patients were in NYHA class I, whereas 59% of Mustard patients were in NYHA class II or III. Peak oxygen uptake was higher in ASO patients (% of predicted 80 vs. 69, p<0.01). Compared to healthy individuals, the mean Tei index for systemic ventricle was high in both groups, but this parameter was significantly higher in Mustard than ASO patients [0.60 (SD=0.16) vs. 0.47 (SD=0.14), p<0.01]. The median plasma N-terminal pro brain natriuretic peptide in ASO patients was within the normal range but the Mustard group had significantly higher levels [42 (18–323) vs. 172 (26–1018), p < 0.0001].
Two decades after surgery the clinical status of patients who underwent ASO was better than the status of Mustard patients. This holds in terms of cardiac function, cardiorespiratory performance and neurohormonal activity.
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Congenital Cardiology Solutions: Outcomes and Resource Utilization in the Adults
Abstract Category: 12. Congenital Cardiology Solutions: Adult
Presentation Number: 1290-118
- 2013 American College of Cardiology Foundation