Early identification of patients at risk for sinus node dysfunction after Mustard operation

F. Drago, A. Turchetta, A. Calzolari, S. Giannico, S. Marianeschi, R. Di Donato, D. Di Carlo, P. Ragonese, C. Marcelletti

Research output: Contribution to journalArticlepeer-review


We studied 60 patients who had survived the Mustard procedure for transposition of the great arteries, performed between the ages of 2 days and 24 months (mean 4.51 ± 3.79). All patients were given a postoperative 24-hour dynamic electrocardiogram at 15 days, 1 year and 3 years and then every 2 years. Those who were found to have sinus node dysfunction during follow-up, were given a dynamic electrocardiogram every 3-6 months. The average follow-up period was 38.7 ± 19.8 months, median 36. Sinus node dysfunction was detected during follow-up in 20 patients (33.3% of the total), 8 of whom had had a pacemaker inserted. Risk factors for late development of sinus node dysfunction were found to include prolonged cross-clamping of the aorta during surgery (P = 0.003), especially over 50 minutes (relative risk 3.5:1), and the presence of even transient sinus node dysfunction after surgery (P = 0.006). These observations suggest, first, that sinus node dysfunction may develop after the Mustard operation as a combined effect of extensive atrial surgery and a long period of myocardial ischemia and, second, that the presence of the disease immediately after the operation sometimes indicates that it will recur or persist during follow-up.

Original languageEnglish
Pages (from-to)27-32
Number of pages6
JournalInternational Journal of Cardiology
Issue number1
Publication statusPublished - 1992


  • Electrocardiogram, 24-hour dynamic
  • Mustard operation
  • Sinus node dysfunction
  • Transposition of the great arteries

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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