Faculty Collaboration Database

Late Survival and Patient-Perceived Health Status of the Congenital Heart Surgeons' Society dextro-Transposition of the Great Arteries Cohort. Ann Thorac Surg 2019 Nov;108(5):1447-1455

Date

07/28/2019

Pubmed ID

31348901

DOI

10.1016/j.athoracsur.2019.05.081

Scopus ID

2-s2.0-85072801006 (requires institutional sign-in at Scopus site)   9 Citations

Abstract

BACKGROUND: Improved survival for patients with dextro-transposition of the great arteries (d-TGA) has led to an increased focus on functional health status (FHS). We assessed late survival and patient-perceived FHS for repaired TGA patients.

METHODS: From 1985-1990, 830 neonates admitted to 24 Congenital Heart Surgeons' Society (CHSS) institutions with d-TGA underwent repair, including 516 arterial switch, 110 Mustard, 175 Senning, and 29 Rastelli operations. Median follow-up was 24.0 years (range, 0-32.7 years). We performed multiphase parametric hazard analysis for death after repair. Patients completed Pediatric Quality of Life Inventory (PedsQL) Core Scales and Cardiac Module Adult Forms. Patient and operative factors and CHSS General Questionnaire responses were analyzed for association with FHS using multiple linear regression.

RESULTS: Survival at 30 years after repair was arterial switch, 80% ± 2%; Mustard, 81% ± 5%; Senning, 70% ± 4%; and Rastelli, 86% ± 8%. The arterial switch had the lowest hazard for late death. TGA patients reported FHS similar to a healthy population in all domains except physical health (lower scores). Symptoms, including chest pain and fainting, and having a pacemaker were associated with lower, and being employed with higher, self-reported physical health. Arterial switch patients reported higher FHS than the atrial switch patients in all domains.

CONCLUSIONS: Arterial switch patients have a lower risk of premature death and better FHS than those with an atrial switch. Increased surveillance in atrial switch patients is warranted because of their increased risk of late death. Presence of symptoms, pacemaker, and lack of employment are associated with reduced FHS.

Author List

Devlin PJ, Jegatheeswaran A, Williams WG, Blackstone EH, DeCampli WM, Lambert LM, Mussatto KA, Prospero CJ, Bondarenko I, McCrindle BW

Author

Kathleen Mussatto Ph.D. Associate Professor in the School of Nursing department at Milwaukee School of Engineering

MESH terms used to index this publication - Major topics in bold

Adult
Cardiac Surgical Procedures
Cohort Studies
Diagnostic Self Evaluation
Female
Follow-Up Studies
Health Status
Humans
Infant
Infant, Newborn
Male
Survival Rate
Time Factors
Transposition of Great Vessels