Recent Experiences with the Mustard Procedure for the Complete Transposition of the Great Arteries by Means of “Bypass Hypothermia”

Abstract

Mustard procedure (intra-atrial baffle operation) for the complete transposition of the great arteries performed is reported in 24 infants and children. All intracardiac repairs were performed using bypass hypothermia (surface-induced deep hypothermia, circulatory arrest and limited cardiopulmonary bypass). The hospital mortality rate was 8% in patients with simple transposition without pulmonary hypertension (Group I, 1 death in 12 patients), 50% in patients with ventricular septal defect (VSD) and pulmonary hypertension (Group II, 3 deaths in 6 patients), and 20% in patients with VSD and pulmonary stenosis (Group III, 1 death in 5 patients). Various types of longstanding arrhythmia were found in 6 out of 18 long-term survivors and subsequent pace-maker implantation was necessary in 1 infant. Postoperative pulmonary venous obstruction occurred in 3 infants and surgical relief of the obstruction was successful in 2. Prevention of postoperative arrhythmia, pulmonary venous obstruction and possible brain damage are discussed.