ATRIAL BAFFLE PROCEDURES FOR COMPLETE TRANSPOSITION OF THE GREAT-ARTERIES - NATURAL COURSE OF SINUS NODE DYSFUNCTION AND RISK-FACTORS FOR DYSRHYTHMIAS AND SUDDEN-DEATH
J. Janousek et al., ATRIAL BAFFLE PROCEDURES FOR COMPLETE TRANSPOSITION OF THE GREAT-ARTERIES - NATURAL COURSE OF SINUS NODE DYSFUNCTION AND RISK-FACTORS FOR DYSRHYTHMIAS AND SUDDEN-DEATH, Zeitschrift fur Kardiologie, 83(12), 1994, pp. 933-938
359 patients after the Mustard (275) or Senning (84) operations for tr
ansposition of the great arteries were followed-up for a mean of 103.7
(range 0.4 to 204) months. 259 patients had postoperative 24-h Holter
recordings. In 129 Mustard children serial (mean 4.4) postoperative H
olter recordings were available for evaluation. Criteria based on Holt
er and scalar electrocardiograms at normal sinus node functions were u
sed for rhythm analysis. Postoperative dysrhythmias appeared in 70% of
the patients: sinus node dysfunction in 62.8%, second or third degree
atrioventricular block in 3.2%, sustained atrial tachycardia or atria
l flutter in 4.5%, and significant ventricular arrhythmia (Lown 2-5) i
n 21.4%. The prevalence of sinus node dysfunction increased slightly f
rom 50.8% during the first 2 postoperative years to 64.4% in patients
more than 10 years postoperatively. Fifteen patients (4.2%) died sudde
nly during follow-up. By multivariate analysis severe tricuspid regurg
itation and/or right ventricular dysfunction and uncontrolled supraven
tricular tachydysrhythmias were identified as the two significant risk
factors for sudden death.