LONG-TERM RESULTS OF ATRIAL CORRECTION FOR TRANSPOSITION OF THE GREAT-ARTERIES - COMPARISON OF MUSTARD AND SENNING OPERATIONS

Few data exists on the differences in long-term outcome between Mustar d and Senning operations. We reviewed available data of all hospital s urvivors of these operations and assessed risk factors for late death and sinus node dysfunction. Of those patients undergoing the Mustard o peration, 60 were hospital survivors (46 simple transposition, 14 comp lex); of those patients undergoing the Senning operation, 62 were hosp ital survivors (43 simple, 19 complex). Median duration of follow-up w as 16 yeats (maximum 25 years) for Mustard operation, 11 years (maximu m 20 years) for Senning operation. No reoperations were done, except f or pacemaker implantation. No differences were found between the two g roups with regard to baffle-associated problems, right ventricular fai lure, sudden death (6% in both groups), and functional status at final follow-up (New York Heart Association class I or II except for four p atients). For patients undergoing the Mustard operation, survival at 1 6-year follow-up was 91% with simple transposition and 60% with comple x transposition (p = 0.027); for both groups of: patients undergoing t he Senning operation, survival at 16-year follow-up was 78%. Survival in the absence of rhythm disturbance at 16-year follow-up was 18% for Mustard operation and 53% for Senning operation (p < 0.001). In multiv ariate analysis, significant,independent risk factors for late death t urned out to be complex transposition (versus simple) and active arrhy thmias. The only significant risk factor for the occurrence of sinus n ode dysfunction was the Mustard operation. We conclude that apart from the difference in the loss of sinus rhythm, no differences were found in the long-term clinical results of the two types of operations.