As with many studies on congenital heart disease patient numbers are small in this study.
Furthermore, we realize that a direct comparison between the results of Mustard and arte-rial switch patients in the same era would be the best possible study design. However, this is not feasible as nowadays all our TGA patients undergo an arterial switch operation. The study design, using the same tests after a comparable follow-up period and at the same age, seems the second best option. The two groups differ in several aspects: not only have surgical treatment feasibilities and age at repair changed, but anaesthetic techniques and neonatal
Long term outcome of arterial switch operation 35
care have improved. Both groups were the first cohort of patients using that specific surgery, therefore results of more recent patients may be slightly different. Although patients were lost of follow-up due to foreign citizenship, the cohort described represents all arterial switch patients still under regular follow-up.
concLusion
Long-term follow-up after arterial switch operation shows excellent survival, low morbidity and favourable quality of life and is clearly better when compared to the outcome after Mus-tard operation. Good cardiac function is the norm after ASO. However, results indicated lower than expected exercise capacity, the ongoing risk of developing important neo-aortic root dilatation with neo-aortic regurgitation. Re-interventions for pulmonary artery problems did occur. Careful systematic clinical follow-up is warranted to monitor these patients further.
AcKnowLEdgEmEnTs
We would like to thank Denise van der Linde en Petra Opic for their help with statistical analyses and Professor Hall for his support in the English grammar.
Chapter 2 36
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