{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T04:05:17Z","timestamp":1783051517333,"version":"3.54.6"},"reference-count":57,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,11,5]]},"abstract":"\n Background<\/jats:title>\n \n Existing data on predictors of late mortality and prevention of sudden cardiac death after atrial switch repair surgery for D\u2010transposition of the great arteries (D\u2010\n TGA<\/jats:styled-content>\n ) are heterogeneous and limited by statistical power.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We conducted a systematic review and meta\u2010analysis of 29 observational studies, comprising 5035 patients, that reported mortality after\n atrial switch repair<\/jats:styled-content>\n with a minimum follow\u2010up of 10\u00a0years. We also examined 4 additional studies comprising 105 patients who reported rates of implantable cardioverter\u2010defibrillator therapy in this population. Average survival dropped to 65% at 40\u00a0years after\n atrial switch repair<\/jats:styled-content>\n , with\n sudden cardiac death<\/jats:styled-content>\n accounting for 45% of all reported deaths. Mortality was significantly lower in cohorts that were more recent and operated on younger patients. Patient\u2010level risk factors for late mortality were history of supraventricular tachycardia (\n odds ratio [OR]<\/jats:styled-content>\n 3.8, 95%\n CI<\/jats:styled-content>\n 1.4\u201310.7), Mustard procedure compared with Senning (\n OR<\/jats:styled-content>\n 2.9, 95%\n CI<\/jats:styled-content>\n 1.9\u20134.5) and complex D\u2010\n TGA<\/jats:styled-content>\n compared with simple D\u2010\n TGA<\/jats:styled-content>\n (\n OR<\/jats:styled-content>\n 4.4, 95%\n CI<\/jats:styled-content>\n 2.2\u20138.8). Significant risk factors for\n sudden cardiac death<\/jats:styled-content>\n were history of\n supraventricular tachycardia<\/jats:styled-content>\n (\n OR<\/jats:styled-content>\n 4.7, 95%\n CI<\/jats:styled-content>\n 2.2\u20139.8), Mustard procedure (\n OR<\/jats:styled-content>\n 2.2, 95%\n CI<\/jats:styled-content>\n 1.1\u20134.1), and complex D\u2010\n TGA<\/jats:styled-content>\n (\n OR<\/jats:styled-content>\n 5.7, 95%\n CI<\/jats:styled-content>\n 1.8\u201318.0). Out of a total 124\n implantable cardioverter\u2010defibrillator<\/jats:styled-content>\n discharges over 330 patient\u2010years in patients with\n implantable cardioverter\u2010defibrillator<\/jats:styled-content>\n s for primary prevention, only 8% were appropriate.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Patient\u2010level risk of both mortality and\n sudden cardiac death<\/jats:styled-content>\n after\n atrial switch repair<\/jats:styled-content>\n are significantly increased by history of\n supraventricular tachycardia<\/jats:styled-content>\n , Mustard procedure, and complex D\u2010\n TGA<\/jats:styled-content>\n . This knowledge may help refine current selection practices for primary prevention\n implantable cardioverter\u2010defibrillator<\/jats:styled-content>\n implantation, given disproportionately high rates of inappropriate discharges.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.119.012932","type":"journal-article","created":{"date-parts":[[2019,10,23]],"date-time":"2019-10-23T09:12:07Z","timestamp":1571821927000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":47,"title":["Predictors of Late Mortality in D\u2010Transposition of the Great Arteries After Atrial Switch Repair: Systematic Review and Meta\u2010Analysis"],"prefix":"10.1161","volume":"8","author":[{"given":"Prashanth","family":"Venkatesh","sequence":"first","affiliation":[{"name":"Division of Cardiology Departments of Medicine and Pediatrics Weill Cornell Medicine New York Presbyterian Hospital Cornell Center for Adult Congenital Heart Disease New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur T.","family":"Evans","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine Weill Cornell Medicine New York Presbyterian Hospital New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna M.","family":"Maw","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine Weill Cornell Medicine New York Presbyterian Hospital New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond A.","family":"Pashun","sequence":"additional","affiliation":[{"name":"Division of Cardiology Departments of Medicine and Pediatrics Weill Cornell Medicine New York Presbyterian Hospital Cornell Center for Adult Congenital Heart Disease New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agam","family":"Patel","sequence":"additional","affiliation":[{"name":"Division of Cardiology Departments of Medicine and Pediatrics Weill Cornell Medicine New York Presbyterian Hospital Cornell Center for Adult Congenital Heart Disease New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology Departments of Medicine and Pediatrics Weill Cornell Medicine New York Presbyterian Hospital Cornell Center for Adult Congenital Heart Disease New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dmitriy","family":"Feldman","sequence":"additional","affiliation":[{"name":"Division of Cardiology Departments of Medicine and Pediatrics Weill Cornell Medicine New York Presbyterian Hospital Cornell Center for Adult Congenital Heart Disease New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Minutello","sequence":"additional","affiliation":[{"name":"Division of Cardiology Departments of Medicine and Pediatrics Weill Cornell Medicine New York Presbyterian Hospital Cornell Center for Adult Congenital Heart Disease New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Chiu","family":"Wong","sequence":"additional","affiliation":[{"name":"Division of Cardiology Departments of Medicine and Pediatrics Weill Cornell Medicine New York Presbyterian Hospital Cornell Center for Adult Congenital Heart Disease New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judy C.","family":"Stribling","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine Samuel J. Wood Library Myra Mahon Patient Resource Center New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damian","family":"LaPar","sequence":"additional","affiliation":[{"name":"Division of Cardiology Departments of Medicine and Pediatrics Weill Cornell Medicine New York Presbyterian Hospital Cornell Center for Adult Congenital Heart Disease New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"Holzer","sequence":"additional","affiliation":[{"name":"Division of Cardiology Departments of Medicine and Pediatrics Weill Cornell Medicine New York Presbyterian Hospital Cornell Center for Adult Congenital Heart Disease New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Ginns","sequence":"additional","affiliation":[{"name":"Division of Cardiology Departments of Medicine and Pediatrics Weill Cornell Medicine New York Presbyterian Hospital Cornell Center for Adult Congenital Heart Disease New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emile","family":"Bacha","sequence":"additional","affiliation":[{"name":"Division of Cardiology Departments of Medicine and Pediatrics Weill Cornell Medicine New York Presbyterian Hospital Cornell Center for Adult Congenital Heart Disease New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harsimran S.","family":"Singh","sequence":"additional","affiliation":[{"name":"Division of Cardiology Departments of Medicine and Pediatrics Weill Cornell Medicine New York Presbyterian Hospital Cornell Center for Adult Congenital Heart Disease New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","first-page":"966","article-title":"Surgical correction of transposition of the great vessels","volume":"45","author":"Senning A","year":"1959","unstructured":"Senning A. 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