PMID- 1934408
OWN - NLM
STAT- MEDLINE
DCOM- 19911216
LR  - 20071115
IS  - 0009-7322 (Print)
IS  - 0009-7322 (Linking)
VI  - 84
IP  - 5 Suppl
DP  - 1991 Nov
TI  - Risk factors for arrhythmia and death after Mustard operation for simple 
      transposition of the great arteries.
PG  - III187-92
AB  - From 1965 to 1980, 249 consecutive patients underwent a Mustard procedure for 
      simple transposition of the great arteries. Hospital mortality was 23 of 249 
      (9.2%); follow-up for 24 years (mean, 11.7 +/- 6.1 yr) revealed 50 of 249 (20%) 
      late deaths, of which seven were noncardiac, six were in the hospital, and 37 
      were sudden (27 patients with poor hemodynamics and 10 unexplained). Actuarial 
      survival after 1, 10, and 20 years was 85, 75, and 67%. The instantaneous risk of 
      death decreased rapidly after surgery but showed a second peak from 8 to 15 years 
      postoperation. When last seen 87% were in New York Heart Association (NYHA) class 
      I; 69% had sinus rhythm, 20% nodal rhythm, 10% atrial flutter, and 1% paced. 
      Survival in uninterrupted sinus rhythm after 5, 10, and 20 years was 75, 62, and 
      47%. Nodal rhythm detected by annual ECG occurred in 69 patients. Excluding the 
      early experience, the risk of loss of sinus rhythm was constant in time and 
      constant throughout the experience (2.4%/yr). Atrial flutter was observed in 36 
      patients. Occurrence of atrial flutter was limited to two discrete surgical 
      periods: the first operations (26 with atrial flutter of the first 50) and an 
      ill-defined period in the middle of the experience. Patients not operated on 
      during these two periods were very unlikely to develop atrial flutter (one of 
      104, p less than 0.001). As for death, the hazard function showed a bimodal 
      curve, the second peak appearing earlier from 5 to 11 years. If nodal rhythm was 
      noted on the yearly routine ECG, the risk for developing subsequent atrial 
      flutter increased by a factor of 2.1 (p less than 0.05).(ABSTRACT TRUNCATED AT 
      250 WORDS)
FAU - Gewillig, M
AU  - Gewillig M
AD  - Department of Pediatric Cardiology, Hospital for Sick Children, London, England.
FAU - Cullen, S
AU  - Cullen S
FAU - Mertens, B
AU  - Mertens B
FAU - Lesaffre, E
AU  - Lesaffre E
FAU - Deanfield, J
AU  - Deanfield J
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Circulation
JT  - Circulation
JID - 0147763
SB  - IM
MH  - Actuarial Analysis
MH  - Arrhythmias, Cardiac/*mortality
MH  - Cardiac Surgical Procedures/*mortality
MH  - Child, Preschool
MH  - Electrocardiography
MH  - Follow-Up Studies
MH  - Hospital Mortality
MH  - Humans
MH  - Postoperative Complications/mortality
MH  - Regression Analysis
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Time Factors
MH  - Transposition of Great Vessels/mortality/*surgery
EDAT- 1991/11/01 00:00
MHDA- 1991/11/01 00:01
CRDT- 1991/11/01 00:00
PHST- 1991/11/01 00:00 [pubmed]
PHST- 1991/11/01 00:01 [medline]
PHST- 1991/11/01 00:00 [entrez]
PST - ppublish
SO  - Circulation. 1991 Nov;84(5 Suppl):III187-92.