Transposition of the great arteries: late results in adolescents and adults after the Mustard procedure. Heart 1987;58:148155. PM, Ingjer F, Thaulow E- Physical activity in children and adolescents \.th congenital heart disease. Aspects of measurements wi

SUMMARY A selected group of 18 patients aged 15-27 years with transposition of the great arteries and a previous Mustard procedure were evaluated to determine their functional ability and clinical state. Arrhythmias were common, occurring at some time in 16/18 (89%). Arrhyth-mia was serious in four; two of them required pacing and two had cardiac arrests, one resulting in death. Seven (41 %) had right ventricular dysfunction; this was progressive in three. Tricuspid regurgitation was present in seven (41%); it occurred in patients with normal and reduced right ventricular ejection fractions. Regurgitation became progressively worse as the right ventricle dilated. Left ventricular function was well preserved in most patients. Fourteen (82%) of this pioneer group were leading normal lives (ability index 1 or 2). Although these results are acceptable concern remains about the probability of deteriorating right ventric-ular function. The introduction of an intra-atrial baffle repair for transposition of the great arteries (the Mustard pro-cedure) in 19641 dramatically changed the prognosis of babies born with this anomaly. Concern about the long term results remains, particularly the capacity of the tricuspid valve and right ventricle to support systemic pressure for many years. Much has been written about the short and medium term results of the Mustard procedure, but little is known about the long term functional ability of these patients when they become adults. We evaluated a selected group of survivors who reached adulthood after the Mustard procedure. Patients and methods We studied all patients with angiographically proven transposition of the great arteries and a pre-vious Mustard operation who were seen at the National Heart Hospital, London, since 1965 and who survived beyond the age of 14 years. All patients were referred from the Hospital for Sick Children in London. There were 18 patients age