Hemodynamic Data and Angiographic Findings after Mustard Repair for Complete Transposition of the Great Arteries

Abstract

Eleven childrern with uncomplicated transposition of the great arteries repaired by the Mustard procedure were studied by atrial pacing, cardiac catheterization, and cineangiography. Nine had persistent postoperative ectopic cardiac rhythms. Atrial pacing in five suggested sinus node damage in four and A-V junctional conduction tissue damage in one. In seven children dye-dilution curves indicated small right-to-left shunts. In all seven superior vena cava cineangiograms showed leaks in the baffle at the superior atrial junction. In the other 10, sequential pressures in the superior vena cava, physiologic right atrium, and inferior vena cava showed no evidence of obstruction to systemic venous return. The three complications related to placement of the atrial baffle seemed to be due in large part to technical difficulties in suturing the baffle in the vulnerable sinus node region. There were no differences in the postoperative hemodynamics between the five patients repaired at a younger age because of severe cyanosis and the five larger children who had been repaired electively. Our results support the aim for early surgical correction in uncomplicated transposition of the great arteries.