European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2026
Long-Term Results After Senning and Mustard Operations for d-Transposition of the Great Arteries: Atrial Switch Should Remain in Armamentarium.
СтатьяНазвание и аннотация: Перевод в очереди
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Kari Fabian A, Ortac Emre, Michel Sebastian G, Cleuziou Julie, Heinisch Paul P, Alalawi Zahra, von Scheidt Fabian, Kienmoser Doris, Ono Masamichi, Kämmerer Harald, Meisner Hans, Lange Rüdiger, Hörer Jürgen
Аннотация
OBJECTIVES: The Senning and Mustard atrial switch procedures, once the standard surgical treatment for transposition of the great arteries, carry the long-term risks linked to a systemic right ventricle.
METHODS: A retrospective follow-up study was conducted to characterize long-term outcomes focusing on survival, baffle-related, and non-baffle-related reoperations.
RESULTS: N = 417 patients with d-transposition of the great arteries (d-TGA) (70% male) were treated with an atrial switch operation in one centre (n = 88 Mustard, n = 329 Senning, treated in 1974-2001). The mean follow-up time was 29.7 (SD 14.2) years, with a median follow-up of 34.2 years (range 10-50 years). The average age of the patients at the last follow-up was 30.9 (SD 14.1) years. Overall survival at 40 years was 78.3% (95% CI, 74.0%-82.8%) with n = 128 patients under observation. Forty-year survival was 81.6% (95% CI, 77.0%-86.5%, n = 91 at risk) after Senning and 66.7% (95% CI, 57.2%-77.8%, n = 37 at risk) after Mustard (log-rank P < .001). Freedom from reoperation at 40 years was 73.1% (95% CI, 68.4%-78.0%). After the Senning, long-term survival over 4 decades was slightly inferior to survival of a general population sample.
CONCLUSIONS: Given a survival up to the fifth life decade only slightly inferior to a normal population and superiority of the Senning over the Mustard operation, the Senning should remain in the congenital cardiac surgeons' armamentarium for late presentation of TGA, ccTGA, and other indications.
CLINICAL REGISTRATION NUMBER: The study is designed as a retrospective study.
METHODS: A retrospective follow-up study was conducted to characterize long-term outcomes focusing on survival, baffle-related, and non-baffle-related reoperations.
RESULTS: N = 417 patients with d-transposition of the great arteries (d-TGA) (70% male) were treated with an atrial switch operation in one centre (n = 88 Mustard, n = 329 Senning, treated in 1974-2001). The mean follow-up time was 29.7 (SD 14.2) years, with a median follow-up of 34.2 years (range 10-50 years). The average age of the patients at the last follow-up was 30.9 (SD 14.1) years. Overall survival at 40 years was 78.3% (95% CI, 74.0%-82.8%) with n = 128 patients under observation. Forty-year survival was 81.6% (95% CI, 77.0%-86.5%, n = 91 at risk) after Senning and 66.7% (95% CI, 57.2%-77.8%, n = 37 at risk) after Mustard (log-rank P < .001). Freedom from reoperation at 40 years was 73.1% (95% CI, 68.4%-78.0%). After the Senning, long-term survival over 4 decades was slightly inferior to survival of a general population sample.
CONCLUSIONS: Given a survival up to the fifth life decade only slightly inferior to a normal population and superiority of the Senning over the Mustard operation, the Senning should remain in the congenital cardiac surgeons' armamentarium for late presentation of TGA, ccTGA, and other indications.
CLINICAL REGISTRATION NUMBER: The study is designed as a retrospective study.