Transplantation after Mustard operation for transposition of the great arteries

Eight pediatric cardiac centers pooled clinical and ECG data from 372 patients who survived the Mustard operation (intraatrial baffle directing pulmonary venous blood to the tricuspid orifice and systemic venous blood to the mitral orifice) for at least 3 months. The follow-up period ranged from 0.4 to 15.9 years, and the mean age at operation was 2 years. The mean resting heart rate for patients who had the Mustard operation was consistently lower than age-matched controls. During the year of operation, 76% of patients had normal sinus rhythm; this percentage declined yearly to 57% by the end of the eighth postoperative year. Active arrhythmias increased after the tenth year. Second or third-degree heart block occurred in 33% of patients during the year of operation and changed very little thereafter. Of the total 372 patients, 39 received pacemakers, 52% during the year of surgery and 48% evenly distributed throughout the follow-up period.

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Right ventricular function 10 years after the Mustard operation for transposition of the great arteries: analysis of size, shape, and wall motion.

Heart ◽

10.1136/hrt.62.6.455 ◽

1989 ◽

Vol 62 (6) ◽

pp. 455-461 ◽

Cited By ~ 50

Author(s):

A N Redington ◽

M L Rigby ◽

P Oldershaw ◽

D G Gibson ◽

E A Shinebourne

Keyword(s):

Right Ventricular ◽

Ventricular Function ◽

Right Ventricular Function ◽

Wall Motion ◽

Mustard Operation

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Mustard operation for transposition of the great arteries in the first three months of life

The American Journal of Cardiology ◽

10.1016/s0002-9149(79)80045-4 ◽

1979 ◽

Vol 43 (2) ◽

pp. 346 ◽

Cited By ~ 1

Keyword(s):

Mustard Operation

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Placement of endovascular stents for systemic venous obstruction after the Mustard operation

Cardiology in the Young ◽

10.1017/s1047951100002390 ◽

1994 ◽

Vol 4 (4) ◽

pp. 390-394 ◽

Cited By ~ 1

Author(s):

Jassim M. Abdulhamed ◽

Saad Al Yousef ◽

Mohamed A. Ali Khan ◽

Martin O'Laughlin

Keyword(s):

Balloon Catheter ◽

Balloon Dilation ◽

The Other ◽

Complete Relief ◽

Venous Obstruction ◽

Endovascular Stents ◽

The Third ◽

Mustard Operation ◽

First Case ◽

Stenotic Area

AbstractThree patients aged five years, five years four months and 14 years with obstruction of the systemic venous baffle following the Mustard operation were treated with balloon dilation and implantation ofstents. Balloon dilation of the baffle obstruction was performed initially in the first two cases. In the third case, the obstruction was complete and was punctured with atranseptal needle via a 6 French transeptal sheath followed by a balloon dilation. in all three patients, a Palmaz stent (Johnson & Johnson, Summerville, New Jersey, USA) was loaded onto the balloon catheter and delivered into the stenotic area. There was complete relief of obstruction in allcases. The first case developed supraventricular tachycardia at the time ofcatheterization, the morning following implantation of the stent and thentwo weeks after that. There were no complications with catheterization and noshort-term side effects in the other cases. These cases illustrate the use of endovascular stents in the treatment of baffle obstruction.

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Characterization of morphology and function of the ‘neo-atria’ after a modified Mustard operation

Global Cardiology Science and Practice ◽

10.21542/gcsp.2021.21 ◽

2021 ◽

Vol 2021 (3) ◽

Author(s):

Mohamed Nagy ◽

Hatem Hosny ◽

Amr El Sawy ◽

Ahmed Mahgoub ◽

Magdi H Yacoub

Keyword(s):

Contractile Function ◽

Postoperative Recovery ◽

Long Term Results ◽

3D Segmentation ◽

Mustard Operation ◽

The Right ◽

And Function ◽

Atrial Systole

Background: There is a pressing need to improve early and long-term results of the Mustard operation. A modification of the operation was introduced at the Aswan Heart Centre for this purpose which relies on creating new functional atria rather than the two rigid channels in the classical Mustard operation.Objectives: To evaluate the morphology and function of the neo-atria, shortly after modified mustard operation for a ‘neglected’ patient with TGA, VSD and severe pulmonary hypertension.Methods: A 6-year-old with neglected TGA, VSD and pulmonary hypertension presented with severe cyanosis, clubbing and haemoconcentration (Hb 22 g/dL), underwent the modified Aswan-Mustard operation (MAM) with rapid smooth postoperative recovery. Repeated 2D echograms and multi-slice CT scans, followed by 3D segmentation, were performed after the operation. The size, shape, and morphology of the neo-atria were measured and measurements of the patterns of instantaneous filling and emptying of the right and left ventricles were quantified.Results: The neo-systemic venous atrium consisted of three components with a combined volume of 78 mL/m2, all of which contributed to the reservoir, conduit, and importantly contractile function of the neo-atrium. The pulmonary venous atrium consisted of two components with a combined volume of 66 mL/m2. These measurements were made at atrial end diastole. The volumes of the systemic venous and the pulmonary venous diminished to 51 and 54 mL/m2, respectively, at the end atrial systole - indicating relatively preserved contractile functions.

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