Ventricular arrhythmias and sudden death in adults after a Mustard operation for transposition of the great arteries

Schwerzmann, Markus; Salehian, Omid; Harris, Louise; Siu, Samuel C; Williams, William G; Webb, Gary D; Colman, Jack M; Redington, Andrew; Silversides, Candice K (2009). Ventricular arrhythmias and sudden death in adults after a Mustard operation for transposition of the great arteries. European Heart Journal, 30(15), pp. 1873-9. Oxford: Oxford University Press 10.1093/eurheartj/ehp179

[img]
Preview
Text
ehp179.pdf - Published Version
Available under License Publisher holds Copyright.

Download (201kB) | Preview

AIMS: To examine the prevalence of sustained ventricular tachycardia (VT) and sudden death (SD) in adults with atrial repair of transposition of the great arteries (TGA) and to determine associated risk factors. METHODS AND RESULTS: In a single-centre review, we studied the outcome of 149 adults (mean age 28 +/- 7 years) who had undergone a Mustard operation for TGA. During a mean follow-up of 9 +/- 6 years, sustained VT and/or SD occurred in 9% (13/149) of the cohort. Sustained VT/SD was more likely to occur in patients with associated anatomic lesions [hazard ratio (HR) 4.9, 95% CI 1.5-16.0], with NYHA class >or=III (HR 9.8, 95% CI 3.0-31.6) and with an impaired subaortic right ventricular (RV) ejection fraction (EF) (HR 2.2, 95% CI 1.2-4.0 per 10% decrease in EF). There was an inverse correlation between the RV-EF and both age and QRS duration. Patients with a QRS duration >or=140 ms were at highest risk of sustained VT/SD (HR 13.6, 95% CI 2.9-63.4). Atrial tachyarrhythmia was detected in 66 (44%) patients, but was not a statistically significant predictor of sustained VT/SD in our adult population (HR 2.7, 95% CI 0.6-13.0). CONCLUSION: Sustained VT/SD in adults after a Mustard operation for TGA are more common than previously described. Age, systemic ventricular function, and QRS duration are interrelated and are associated with VT/SD. A QRS duration >or=140 ms helps to identify the high risk patient.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Schwerzmann, Markus

ISSN:

0195-668X

Publisher:

Oxford University Press

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 15:14

Last Modified:

23 Oct 2019 23:43

Publisher DOI:

10.1093/eurheartj/ehp179

PubMed ID:

19465439

Web of Science ID:

000268806100016

BORIS DOI:

10.7892/boris.32485

URI:

https://boris.unibe.ch/id/eprint/32485 (FactScience: 197716)

Actions (login required)

Edit item Edit item
Provide Feedback