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Ann Thorac Surg 1986;42:385-389
© 1986 The Society of Thoracic Surgeons
From the Department of Cardiovascular Surgery, the Children's Hospital of Buffalo, State University of New York at Buffalo, Buffalo, NY
* Address reprint requests to Dr. Subramanian, Division of Cardiovascular Surgery, The Children's Hospital of Buffalo, 219 Bryant St, Buffalo, NY 14222
Between 1967 and 1976, 106 children with transposition of the great arteries (TGA) (55 simple, 51 complex) survived the Mustard procedure. Late death occurred in 8 patients (1 simple, 7 complex TGA). Cardiac arrhythmia developed in 31 patients, 6 of whom required a permanent pacemaker. Postoperative cardiac catheterization showed mild superior vena cava obstruction in 4 patients, mild pulmonary venous obstruction in 3, and baffle leak in 4. Only 1 of these patients underwent reoperation elsewhere for a baffle leak. Two other patients had reoperation for subpulmonary stenosis and 1, for tricuspid regurgitation. The actuarial survival at 18 years is 92 ± 2.3%, and the event-free survival is 83 ± 3.8% (95% confidence limits). Eighty-seven patients are in New York Heart Association Functional Class I, and 3 are in Class II. The results of this study show that the long-term survival and event-free survival have been satisfactory. Late death was significantly higher in patients with complex TGA (p = .027). Postoperative arrhythmia was common, but only 6 patients required permanent pacemakers and the incidence of late complications and reoperation has been low.
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