{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T08:07:23Z","timestamp":1787386043062,"version":"build-2736575974"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T00:00:00Z","timestamp":1774051200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"German Heart Center"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The Senning and Mustard atrial switch procedures, once the standard surgical treatment for transposition of the great arteries, carry the long-term risks linked to a systemic right ventricle.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective follow-up study was conducted to characterize long-term outcomes focusing on survival, baffle-related, and non-baffle-related reoperations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>N\u2009=\u2009417 patients with d-transposition of the great arteries (d-TGA) (70% male) were treated with an atrial switch operation in one centre (n\u2009=\u200988 Mustard, n\u2009=\u2009329 Senning, treated in 1974-2001). The mean follow-up time was 29.7 (SD 14.2) years, with a median follow-up of 34.2 years (range 10-50 years). The average age of the patients at the last follow-up was 30.9 (SD 14.1) years. Overall survival at 40 years was 78.3% (95% CI, 74.0%-82.8%) with n\u2009=\u2009128 patients under observation. Forty-year survival was 81.6% (95% CI, 77.0%-86.5%, n\u2009=\u200991 at risk) after Senning and 66.7% (95% CI, 57.2%-77.8%, n\u2009=\u200937 at risk) after Mustard (log-rank P\u2009&amp;lt;\u2009.001). Freedom from reoperation at 40 years was 73.1% (95% CI, 68.4%-78.0%). After the Senning, long-term survival over 4 decades was slightly inferior to survival of a general population sample.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Given a survival up to the fifth life decade only slightly inferior to a normal population and superiority of the Senning over the Mustard operation, the Senning should remain in the congenital cardiac surgeons\u2019 armamentarium for late presentation of TGA, ccTGA, and other indications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical registration number<\/jats:title>\n                    <jats:p>The study is designed as a retrospective study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejcts\/ezag126","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T12:55:45Z","timestamp":1773838545000},"source":"Crossref","is-referenced-by-count":1,"title":["Long-Term Results After Senning and Mustard Operations for d-Transposition of the Great Arteries: Atrial Switch Should Remain in Armamentarium"],"prefix":"10.1093","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0985-9650","authenticated-orcid":false,"given":"Fabian A","family":"Kari","sequence":"first","affiliation":[{"name":"Department of Pediatric and Congenital Cardiac Surgery, TUM University Hospital German Heart Center , Munich, 80636,","place":["Germany"]},{"name":"Department of Cardiac Surgery, Section of Pediatric and Congenital Cardiac Surgery, LMU University Hospital , Munich 81377,","place":["Germany"]},{"name":"European Pediatric Heart Center EKHZ Munich , Munich,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9921-6962","authenticated-orcid":false,"given":"Emre","family":"Ortac","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Congenital Cardiac Surgery, TUM University Hospital German Heart Center , Munich, 80636,","place":["Germany"]},{"name":"Department of Cardiac Surgery, Section of Pediatric and Congenital Cardiac Surgery, LMU University Hospital , Munich 81377,","place":["Germany"]},{"name":"European Pediatric Heart Center EKHZ Munich , Munich,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian G","family":"Michel","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Congenital Cardiac Surgery, TUM University Hospital German Heart Center , Munich, 80636,","place":["Germany"]},{"name":"Department of Cardiac Surgery, Section of Pediatric and Congenital Cardiac Surgery, LMU University Hospital , Munich 81377,","place":["Germany"]},{"name":"European Pediatric Heart Center EKHZ Munich , Munich,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1971-4375","authenticated-orcid":false,"given":"Julie","family":"Cleuziou","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Congenital Cardiac Surgery, TUM University Hospital German Heart Center , Munich, 80636,","place":["Germany"]},{"name":"Department of Cardiac Surgery, Section of Pediatric and Congenital Cardiac Surgery, LMU University Hospital , Munich 81377,","place":["Germany"]},{"name":"European Pediatric Heart Center EKHZ Munich , Munich,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4061-4499","authenticated-orcid":false,"given":"Paul P","family":"Heinisch","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Congenital Cardiac Surgery, TUM University Hospital German Heart Center , Munich, 80636,","place":["Germany"]},{"name":"Department of Cardiac Surgery, Section of Pediatric and Congenital Cardiac Surgery, LMU University Hospital , Munich 81377,","place":["Germany"]},{"name":"European Pediatric Heart Center EKHZ Munich , Munich,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9175-8114","authenticated-orcid":false,"given":"Zahra","family":"Alalawi","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Congenital Cardiac Surgery, TUM University Hospital German Heart Center , Munich, 80636,","place":["Germany"]},{"name":"Department of Cardiac Surgery, Section of Pediatric and Congenital Cardiac Surgery, LMU University Hospital , Munich 81377,","place":["Germany"]},{"name":"European Pediatric Heart Center EKHZ Munich , Munich,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3431-0862","authenticated-orcid":false,"given":"Fabian","family":"von Scheidt","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Defects and Pediatric Cardiology, TUM University Hospital German Heart Center , Munich,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doris","family":"Kienmoser","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Congenital Cardiac Surgery, TUM University Hospital German Heart Center , Munich, 80636,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5699-6394","authenticated-orcid":false,"given":"Masamichi","family":"Ono","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Congenital Cardiac Surgery, TUM University Hospital German Heart Center , Munich, 80636,","place":["Germany"]},{"name":"Department of Cardiac Surgery, Section of Pediatric and Congenital Cardiac Surgery, LMU University Hospital , Munich 81377,","place":["Germany"]},{"name":"European Pediatric Heart Center EKHZ Munich , Munich,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0789-2684","authenticated-orcid":false,"given":"Harald","family":"K\u00e4mmerer","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Defects and Pediatric Cardiology, TUM University Hospital German Heart Center , Munich,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Meisner","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Congenital Cardiac Surgery, TUM University Hospital German Heart Center , Munich, 80636,","place":["Germany"]},{"name":"Department of Cardiac Surgery, Section of Pediatric and Congenital Cardiac Surgery, 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