Ashraf M H, Cotroneo J, DiMarco D, Subramanian S
Ann Thorac Surg. 1986 Oct;42(4):385-9. doi: 10.1016/s0003-4975(10)60541-3.
Between 1967 and 1976, 106 children with transposition of the great arteries (TGA) (55 simple, 51 complex) survived the Mustard procedure. Late death occurred in 8 patients (1 simple, 7 complex TGA). Cardiac arrhythmia developed in 31 patients, 6 of whom required a permanent pacemaker. Postoperative cardiac catheterization showed mild superior vena cava obstruction in 4 patients, mild pulmonary venous obstruction in 3, and baffle leak in 4. Only 1 of these patients underwent reoperation elsewhere for a baffle leak. Two other patients had reoperation for subpulmonary stenosis and 1, for tricuspid regurgitation. The actuarial survival at 18 years is 92 +/- 2.3%, and the event-free survival is 83 +/- 3.8% (95% confidence limits). Eighty-seven patients are in New York Heart Association Functional Class I, and 3 are in Class II. The results of this study show that the long-term survival and event-free survival have been satisfactory. Late death was significantly higher in patients with complex TGA (p = .027). Postoperative arrhythmia was common, but only 6 patients required permanent pacemakers and the incidence of late complications and reoperation has been low.
1967年至1976年间，106例患有大动脉转位（TGA）的儿童（55例为单纯型，51例为复杂型）在接受Mustard手术后存活。8例患者发生晚期死亡（1例单纯型TGA，7例复杂型TGA）。31例患者出现心律失常，其中6例需要植入永久性起搏器。术后心导管检查显示，4例患者有轻度上腔静脉梗阻，3例有轻度肺静脉梗阻，4例有挡板渗漏。这些患者中只有1例因挡板渗漏在其他地方接受了再次手术。另外2例患者因肺动脉瓣下狭窄接受了再次手术，1例因三尖瓣反流接受了再次手术。18年的精算生存率为92±2.3%，无事件生存率为83±3.8%（95%置信区间）。87例患者纽约心脏协会心功能分级为I级，3例为II级。本研究结果表明，长期生存率和无事件生存率令人满意。复杂型TGA患者的晚期死亡率显著更高（p = 0.027）。术后心律失常很常见，但只有6例患者需要永久性起搏器，晚期并发症和再次手术的发生率较低。
