TY - JOUR
T1 - Long-term outcome and quality of life after arterial switch operation
T2 - A prospective study with a historical comparison
AU - Ruys, Titia P.E.
AU - van der Bosch, Annemien E.
AU - Cuypers, Judith A.A.E.
AU - Witsenburg, Maarten
AU - Helbing, Willem A.
AU - Bogers, Ad J.J.C.
AU - van Domburg, Ron
AU - Mcghie, Jacky S.
AU - Geleijnse, Marcel L.
AU - Henrichs, Jens
AU - Utens, Elisabeth
AU - Van der Zwaan, Heleen B.
AU - Takkenberg, Johanna J.M.
AU - Roos-Hesselink, Jolien W.
PY - 2013/5/1
Y1 - 2013/5/1
N2 - 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.
AB - 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.
KW - Arterial Switch
KW - Long-term Outcome
KW - Mustard Operation
KW - Quality of Life
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=84878737879&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/chd.12033
DO - https://doi.org/10.1111/chd.12033
M3 - Article
C2 - 23350828
SN - 1747-079X
VL - 8
SP - 203
EP - 210
JO - Congenital heart disease
JF - Congenital heart disease
IS - 3
ER -