Background: Until the early ninethies the atrial switch operation was the standard technique for TGA-correction and has given good results. However, its long-term complications (RV-failure,arrhythmias,re-interventions) are well recognized. In contrast, little is known about the QoL of this special subgroup of GUCH-patients following Senning/Mustard-Operation.
Methods:
122 patients (age:23±7years) operated for TGA by Senning/Mustard-Operation(n=102) and Switch-Operation(n=20) were sent a SF-36-questionnaire (health-related QoL), HADS-test (anxiety/depression-aspects), and an additional questionnaire on GUCH-specific problems. The scores were compared with age- and gender-matched standard population data and in relation to the performed operation.
Results:
QoL of Senning/Mustard-patients is comparable to standard population in all SF-36/HADS-healthdimensions, however, is found to be lower in many categories than for Switch-patients. Age was found to have a significant negative impact on the generalhealth-dimension of Senning/Mustard-patients(p<0.05). Re-operation was found to show no significant influence on QoL. More Senning/Mustard-patients(43%) suffer from arrhythmias compared to Switch-patients(p=0.02), 34% requiring treatment(p=0.01). NYHA-functional status revealed throughout higher classes for Senning/Mustrad vs switch. 55% of Senning/Mustard-patients stated to feel limited by their malformation in their physical capacity (21%Switch),21% receive a disability pension (0%Switch).
Conclusions:
QoL of GUCH patients after Senning/Mustard-correction is comparable to the standard population. However, they are found to score significantly lower in many dimensions when compared to arterial switch patients, and show a higher percentage of long-term complications, a lower functional status, and feel more limited in their physical capacity by their malformation.
These findings highlight the great importance for a multidisciplinary and specialized long-term follow-up of this specific subgroup of GUCH patients.