{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T03:38:09Z","timestamp":1788838689320,"version":"build-2803163510"},"reference-count":38,"publisher":"Cambridge University Press (CUP)","issue":"3","license":[{"start":{"date-parts":[[2005,1,21]],"date-time":"2005-01-21T00:00:00Z","timestamp":1106265600000},"content-version":"unspecified","delay-in-days":234,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2004,6]]},"abstract":"<jats:p>Most adults with regular transposition (the combinations of concordant atrioventricular and discordant ventriculo-arterial connections) have undergone either the Mustard or Senning procedure in childhood. It is unclear whether adverse events differ according to the surgery performed. With this in mind, we conducted a systematic review and meta-analysis to compare long-term outcomes. We searched systematically entries to MEDLINE and EMBASE databases from January 1966 through August 2003, supplementing the search by secondary sources. Comparative studies were required to include at least 10 patients in each cohort of Mustard or Senning procedure, and to report overall survival. Data were extracted by two independent reviewers. We used a component approach to assess quality. On the basis of assessment of heterogeneity, we then used a random-effects model for pooled analyses. In all, we included seven studies, incorporating 885 patients. We found a trend towards lower mortality for the 369 patients undergoing a Mustard procedure when compared to 474 submitted to the Senning operation, with a hazard ratio of 0.63 and 95% confidence intervals between 0.35 and 1.14 (p = 0.13). This trend increased with the size of the sample (p = 0.004). Obstruction in the systemic venous pathway was more common in those having the Mustard procedure, with a risk ratio of 3.5 and 95% confidence intervals from 1.8 to 7.0 (p &lt; 0.001), with a trend towards greater obstruction of the pulmonary venous pathway in those undergoing the Senning procedure, 7.6% vs. 3.8% (p = 0.27). A trend towards fewer residual shunts was observed for those with Mustard baffles, 7.0% vs. 14.1% (p = 0.10). Sinus nodal dysfunction, however, was more common after the Mustard procedure. Data regarding atrial tachydysrhythmias was inconclusive. Systemic cardiac failure and functional capacity, was similar. We conclude that outcomes are not uniform among patients submitted to the Mustard and Senning procedures. Knowledge of such differences may facilitate stratification of risk and follow-up.<\/jats:p>","DOI":"10.1017\/s1047951104003063","type":"journal-article","created":{"date-parts":[[2005,1,28]],"date-time":"2005-01-28T15:58:54Z","timestamp":1106927934000},"page":"284-292","source":"Crossref","is-referenced-by-count":159,"title":["Long-term outcomes after the atrial switch for surgical correction of transposition: a meta-analysis comparing the Mustard and Senning procedures"],"prefix":"10.1017","volume":"14","author":[{"given":"Paul","family":"Khairy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Landzberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Lambert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare P.","family":"O'Donnell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2005,1,21]]},"reference":[{"key":"S1047951104003063_ref030","doi-asserted-by":"crossref","unstructured":"Bender HW Jr , Stewart JR , Merrill WH , Hammon JW Jr , Graham TP Jr . 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Herz 1982; 7: 259\u2013266."},{"key":"S1047951104003063_ref019","doi-asserted-by":"crossref","unstructured":"Higgins JP , Thompson SG . Quantifying heterogeneity in a meta-analysis. Stat Med 2002; 21: 1539\u20131558.","DOI":"10.1002\/sim.1186"},{"key":"S1047951104003063_ref018","doi-asserted-by":"crossref","unstructured":"Parmar MK , Torri V , Stewart L . Extracting summary statistics to perform meta-analyses of the published literature for survival endpoints. Stat Med 1998; 17: 2815\u20132834.","DOI":"10.1002\/(SICI)1097-0258(19981230)17:24<2815::AID-SIM110>3.0.CO;2-8"},{"key":"S1047951104003063_ref026","doi-asserted-by":"crossref","unstructured":"Wells WJ , Blackstone E . Intermediate outcomes after Mustard and Senning procedures: a study by the congenital heart surgeons society. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2000; 3: 186\u2013197.","DOI":"10.1053\/tc.2000.6043"},{"key":"S1047951104003063_ref008","doi-asserted-by":"crossref","unstructured":"Gelatt M , Hamilton RM , McCrindle BW , et al. Arrhythmia and mortality after the Mustard procedure: a 30-year single-center experience. J Am Coll Cardiol 1997; 29: 194\u2013201.","DOI":"10.1016\/S0735-1097(96)00424-X"},{"key":"S1047951104003063_ref013","doi-asserted-by":"crossref","unstructured":"Deanfield J , Camm J , Macartney F , et al. Arrhythmia and late mortality after Mustard and Senning operation for transposition of the great arteries. An eight-year prospective study. J Thorac Cardiovasc Surg 1988; 96: 569\u2013576.","DOI":"10.1016\/S0022-5223(19)35210-9"},{"key":"S1047951104003063_ref025","unstructured":"Weidinger F , Schlemmer M , Schmidinger H , Weber H , Domanig E , Wimmer M . Dysrhythmias following the Mustard and Senning operation for transposition of the great arteries. Padiatr Padol 1987; 22: 259\u2013266."},{"key":"S1047951104003063_ref036","unstructured":"Janousek J , Paul T , Luhmer I , Wilken M , Hruda J , Kallfelz HC . Atrial baffle procedures for complete transposition of the great arteries: natural course of sinus node dysfunction and risk factors for dysrhythmias and sudden death. Z Kardiol 1994; 83: 933\u2013938."},{"key":"S1047951104003063_ref010","unstructured":"Stark J , Tynan MJ , Ashcraft KW , Aberdeen E , Waterston DJ . Obstruction of pulmonary veins and superior vena cava after the Mustard operation for transposition of the great arteries. Circulation 1972; 45: I116\u2013I120."},{"key":"S1047951104003063_ref001","doi-asserted-by":"crossref","unstructured":"Brickner ME , Hillis LD , Lange RA . Congenital heart disease in adults. Second of two parts. 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Ann Cardiol Angeiol (Paris) 1985; 34: 33\u201337."},{"key":"S1047951104003063_ref038","doi-asserted-by":"crossref","unstructured":"Stroup DF , Berlin JA , Morton SC , et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. J Am Med Assoc 2000; 283: 2008\u20132012.","DOI":"10.1001\/jama.283.15.2008"},{"key":"S1047951104003063_ref017","doi-asserted-by":"crossref","unstructured":"Mahony L , Turley K , Ebert P , Heymann MA . Long-term results after atrial repair of transposition of the great arteries in early infancy. Circulation 1982; 66: 253\u2013258.","DOI":"10.1161\/01.CIR.66.2.253"},{"key":"S1047951104003063_ref003","unstructured":"Senning A . Surgical correction of transposition of the great vessels. Surgery 1959; 45: 966\u2013979."},{"key":"S1047951104003063_ref023","doi-asserted-by":"crossref","unstructured":"Feder E , Meisner H , Buhlmeyer K , Struck E , Sebening F . 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Transposition of great arteries: atrial inversion \u2013 the Senning versus the Mustard procedure. Arq Bras Cardiol 1982; 38: 385\u2013388."},{"key":"S1047951104003063_ref037","doi-asserted-by":"crossref","unstructured":"Levinsky L , Srinivasan V , Gingell RL , et al. Senning repair with ductal decompression: palliative approach to d-TGA and irreversible pulmonary vascular disease. Am Heart J 1983; 106: 409\u2013412.","DOI":"10.1016\/0002-8703(83)90215-6"},{"key":"S1047951104003063_ref016","unstructured":"Bender HW Jr , Graham TP Jr , Boucek RJ Jr , Walker WE , Boerth RG . Comparative operative results of the Senning and Mustard procedures for transposition of the great arteries. Circulation 1980; 62: I197\u2013I203."},{"key":"S1047951104003063_ref032","doi-asserted-by":"crossref","unstructured":"Breckenridge IM , Stark J , Bonham-Carter RE , Oelert H , Graham GR , Waterston DJ . Mustard\u2019s operation for transposition of the great arteries. Review of 200 cases. Lancet 1972; 1: 1140\u20131142.","DOI":"10.1016\/S0140-6736(72)91372-4"},{"key":"S1047951104003063_ref028","unstructured":"Kugler JD . Sinus node dysfunction. In: Garson A Jr , Bricker JT , McNamara DG (eds). The Science and Practice of Pediatric Cardiology. Lea & Febiger, Philadelphia, 1990, pp 1751\u20131785."},{"key":"S1047951104003063_ref033","doi-asserted-by":"crossref","unstructured":"Rodriguez-Fernandez HL , Kelly DT , Collado A , Haller JA Jr , Krovetz LJ , Rowe RD . Hemodynamic data and angiographic findings after Mustard repair for complete transposition of the great arteries. Circulation 1972; 46: 799\u2013808.","DOI":"10.1161\/01.CIR.46.4.799"},{"key":"S1047951104003063_ref021","unstructured":"J\u00fcni P , Altman DG , Egger M . Assessing the quality of randomised controlled trials. In: Egger M , Smith GD , Altman DG (eds). Systematic Review in Health Care: Meta-analysis in Context. BMJ Publishing Group, London, 2001, pp 87\u2013108."}],"container-title":["Cardiology in the Young"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1047951104003063","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,4,5]],"date-time":"2020-04-05T13:17:27Z","timestamp":1586092647000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1047951104003063\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,6]]},"references-count":38,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2004,6]]}},"alternative-id":["S1047951104003063"],"URL":"https:\/\/doi.org\/10.1017\/s1047951104003063","relation":{},"ISSN":["1047-9511","1467-1107"],"issn-type":[{"value":"1047-9511","type":"print"},{"value":"1467-1107","type":"electronic"}],"subject":[],"published":{"date-parts":[[2004,6]]}}}