Abstract
The long term status of right ventricular function after intra-atrial baffle repair (Mustard) for transposition of the great arteries (TGA) was evaluated. Right ventricular ejection fraction (RVEF) and tricuspid regurgitation (TR) were estimated by radionuclide angiocardiography in 58 pts who were at least 10 yrs post-Mustard (mean age, 14 ± 3 yrs). Mean RVEF of 0.53 ± 0.10 did not differ from our normal. However, in 9 pts the most recent RVEF was < 0.42, placing them > 2SD below normal. Serial RVEF in 32 pts fell from a group mean of 0.54 ± 0.11 to 0.51 ± 0.11 (p < 0.1) over 9 ± 2 yrs. In 10 of these 32, RVEF either dropped to < 0.42 or decreased > 0.10 between studies. Significant TR was present in 27/52, and increased in 8 studied serially. This data demonstrates 1) though group RVEF in adolescent and young adult pts with previous Mustard is normal, almost 17% of pts have depressed function; 2) RVEF often worsens when studied serially in older pts; and 3) TR is significant in over half the previously operated pts. Though most of these post-operative TGA pts are free of clinical symptoms through adolescence, they are at significant risk for deterioration of function.
Published Version
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