Superior Vena Cava Syndrome Following Complete Correction (Mustard Repair) of Transposition of the Great Vessels

Mazzei, Eugene A.; Mulder, Donald G.

doi:10.1016/s0003-4975(10)65445-8

Cited by 36 publications

(2 citation statements)

References 5 publications

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“…'0-"3 The Mustard operation is not totally corrective, however, and there is some concern about the long-term results. As the right ventricle continues to support the systemic circulation and tricuspid regurgitation,14 obstruction of systemic and pulmonary venous drainage'5 16 and late arrhythmiasI7 may constitute serious complications.…”

Section: Discussionmentioning

confidence: 99%

Dual-demand pacing for reciprocating atrioventricular tachycardia.

Krikler¹,

Curry²,

Buffet³

1976

BMJ

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DiscussionThe term complete or D transposition of the great arteries is generally used to indicate the presence of normal or concordant atrioventricular connections with abnormal (transposed) ventriculoarterial connections. In the absence of additional communication between the systemic and pulmonary circulation about 80O of patients die before the age of six months. '-3 In the presence of a large ventricular septal defect 700/% die within the first six months and about 20%o survive to one year.3 Pulmonary vascular disease is more common and occurs earlier (before the age of 1 year) in the presence of a ventricular septal defect.6-8 In patients with an intact ventricular septum the use of atrial septostomy followed by inflow "correction" using the Mustard operation9 has significantly altered the natural history of the disease, with good early results, in several series.'0-"3 The Mustard operation is not totally corrective, however, and there is some concern about the long-term results. As the right ventricle continues to support the systemic circulation and tricuspid regurgitation,14 obstruction of systemic and pulmonary venous drainage'5 16 and late arrhythmiasI7 may constitute serious complications.Total correction of transposition of the great arteries can be accomplished by transecting the aorta and pulmonary artery and reattaching them to the appropriate ventricles. One of the difficulties in applying this technique is the necessity of transposing the coronary ostia, which are very closely related to the aortic valve. The technique described in this paper illustrates the feasibility of this procedure very early in life. Another important consideration for the success of this operation is the state of the left ventricle, which should be capable of supporting the systemic circulation immediately after operation. In patients with transposition of the great arteries and intact ventricular septum the relatively low pulmonary vascular resistance results in diminution in left ventricular mass,'8 which renders it incapable of supporting the circulation after total anatomical correction. This occurs shortly after birth concomittantly with the fall in pulmonary vascular resistance.'9 2 0The technique described in this paper was developed by us in 1972 and initially performed in three children with transposition of the great arteries and intact ventricular septae aged 3 weeks to 3 months. These children developed fatal acute left ventricular failure within hours of operation. For this reason we believe that to be successful the totally corrective procedure in transposition with intact ventricular septum must be performed very early in life. In contrast, the functional state of the left ventricle is maintained in patients with transposition of the great arteries and ventricular septal defect. Nevertheless, the corrective procedure must be applied before the onset of irreversible pulmonary vascular disease, which is thought to occur between the ages of 6 months and 1 year in most cases. Banding of the pulmonary artery ...

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Section: Discussionmentioning

confidence: 99%

Dual-demand pacing for reciprocating atrioventricular tachycardia.

Krikler¹,

Curry²,

Buffet³

1976

BMJ

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“…When both the superior and the inferior systemic venous pathways are obstructed, symptoms are more likely to occur in the form of superior vena cava syndrome, ascites, protein losing enteropathy, and generalized edema [4,5]. Surgical relief of post-Mustard baffle obstruction requiring repeat cardiopulmonary bypass with its attendant morbidity may not always abolish the obstruction, and recurrent narrowing may occur [6].…”

Section: Introductionmentioning

confidence: 99%

Stent implantation for superior vena cava occlusion after the mustard operation

Mohsen

Rosenthal

Qureshi

et al. 2001

Cathet Cardio Intervent

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A 25-year-old man who had undergone a Mustard repair for complete transposition of the great arteries 21 years previously developed complete occlusion of the superior vena cava and obstruction of the inferior vena cava. Transcatheter recanalization was performed using needle puncture of the superior obstruction followed by stent implantation into both systemic venous pathways with relief of obstructive symptoms.

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Bilateral Chylothorax Complicating Mustard Repair of Transposition of the Great Vessels

Copeland¹

1982

Arch Intern Med

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Superior Vena Cava Syndrome Following Complete Correction (Mustard Repair) of Transposition of the Great Vessels

Cited by 36 publications

References 5 publications

Dual-demand pacing for reciprocating atrioventricular tachycardia.

Dual-demand pacing for reciprocating atrioventricular tachycardia.

Stent implantation for superior vena cava occlusion after the mustard operation

Bilateral Chylothorax Complicating Mustard Repair of Transposition of the Great Vessels

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