[Late results and problems after atrial switch operation]

Between 1970 and June 1992, 137 consecutive patients with transposition of the great arteries and double outlet right ventricle underwent an atrial switch operation at the Heart Institute of Japan. They included 74 patients with a Senning operation (Group I) and 63 patients with a Mustard operation (Group II). Ages at operation ranged from 1 month to 15 years (average 25.7 months) and follow-up period in 114 operative survivors ranged from 1 month to 22 years (average 6.8 years in the Senning group, 10.9 years in the Mustard group). Twelve-year actuarial survival rate was 90.1% in Group I and 64.1% in Group II, and 22-year actuarial survival rate was 64.1% in Group II. There were 6 and 13 late deaths in group I and group II, respectively. Sudden Death occurred in 7 patients in the late postoperative period presumably due to arrhythmias, although there were no symptoms and signs of arrhythmias in 4 of the 7 patients. Five other patients died from cardiac failure in the late postoperative period. Ninety-two percent of group I and seventy-one percent of group II maintained normal sinus rhythm evaluated by the electrocardiogram and Holter's electrocardiogram in the late postoperative period. Mean PQ interval in the late postoperative period was 0.14 +/- 0.03 seconds in group I and 0.17 +/- 0.03 seconds in group II; Group II had a higher incidence of arrhythmias than group I.(ABSTRACT TRUNCATED AT 250 WORDS)