Abstract
Twenty-two patients with transposition of the great arteries with or without ventricular septal defect and one with double outlet right ventricle, d-malposition, and severe pulmonary vascular obstructive disease were treated surgically. All were cyanosed and had very limited exercise tolerance. Preoperatively, systemic arterial oxygen saturation (SaO2) varied from 45 to 79% (mean 65), haemoglobin was 13 to 23 g/dl (mean 19). Pulmonary arteriolar resistance was 6.4 to 35 units m2 (mean 17). In the patients with a ventricular septal defect the Mustard operation was done without closure of the ventricular septal defect, and in the 3 patients with intact ventricular septum the Mustard operation was combined with creation of a ventricular septal defect. All patients survived the operation and improved. Postoperative SaO2 ranged from 75 to 96% (mean 89) and haemoglobin from 10.6 to 17.8 g/dl (mean 14.0). This improvement was significant (P less than 0.05). Five patients have had a postoperative cardiac catheterisation. The pulmonary arteriolar resistance remains high in all. Postoperative follow-up varies from 4 to 40 months (mean 14 months). So far there have been no late deaths and all patients remain improved.
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- Bernhard W. F., Dick M., 2nd, Sloss L. J., Castaneda A. R., Nadas A. S. The palliative Mustard operation for double outlet right ventricle or transposition of the great arteries associated with ventricular septal defect, pulmonary arterial hypertension, and pulmonary vascular obstructive disease. A report of eight patients. Circulation. 1976 Nov;54(5):810–817. doi: 10.1161/01.cir.54.5.810. [DOI] [PubMed] [Google Scholar]
- Lindesmith G. G., Stanton R. E., Lurie P. R., Takahashi M., Tucker B. L., Stiles Q. R., Meyer B. W. An assessment of Mustard's operation as a palliative procedure for transposition of the great vessels. Ann Thorac Surg. 1975 May;19(5):514–520. doi: 10.1016/s0003-4975(10)64425-6. [DOI] [PubMed] [Google Scholar]
- Lindesmith G. G., Stiles Q. R., Tucker B. L., Gallaher M. E., Stanton R. E., Meyer B. W. The Mustard operation as a palliative procedure. J Thorac Cardiovasc Surg. 1972 Jan;63(1):75–80. [PubMed] [Google Scholar]
- Mair D. D., Ritter D. G., Danielson G. K., Wallace R. B., McGoon D. C. The palliative Mustard operation: rationale and results. Am J Cardiol. 1976 Apr;37(5):762–768. doi: 10.1016/0002-9149(76)90372-6. [DOI] [PubMed] [Google Scholar]
- Mair D. D., Ritter D. G., Ongley P. A., Helmholz H. F., Jr Hemodynamics and evaluation for surgery of patients with complete transposition of the great arteries and ventricular septal defect. Am J Cardiol. 1971 Dec;28(6):632–640. doi: 10.1016/0002-9149(71)90050-6. [DOI] [PubMed] [Google Scholar]
- Newfeld E. A., Paul M. M., Muster A. J., Idriss F. S. Pulmonary vascular disease in complete transposition of the great arteries: a study of 200 patients. Am J Cardiol. 1974 Jul;34(1):75–82. doi: 10.1016/0002-9149(74)90096-4. [DOI] [PubMed] [Google Scholar]
- Stark J. Operation results for transposition of the great arteries. Adv Cardiol. 1976;17:20–31. doi: 10.1159/000398824. [DOI] [PubMed] [Google Scholar]
- Stark J., Saw S., de Leval M. R., Taylor J. F. Proceedings: Mustard operation in patients with pulmonary vascular disease. Br Heart J. 1976 Mar;38(3):317–317. [PubMed] [Google Scholar]
- Stark J., de Leval M. R., Taylor J. F. Mustard operation and creation of ventricular septal defect in two patients with transposition of the great arteries, intact ventricular septum and pulmonary vascular disease. Am J Cardiol. 1976 Oct;38(4):524–527. doi: 10.1016/0002-9149(76)90472-0. [DOI] [PubMed] [Google Scholar]
- Viles P. H., Ongley P. A., Titus J. L. The spectrum of pulmonary vascular disease in transposition of the great arteries. Circulation. 1969 Jul;40(1):31–41. doi: 10.1161/01.cir.40.1.31. [DOI] [PubMed] [Google Scholar]
- Wagenvoort C. A., Nauta J., van der Schaar P. J., Weeda H. W., Wagenvoort N. The pulmonary vasculature in complete transpossition of the greatvessels, judged from lung biopsies. Circulation. 1968 Oct;38(4):746–754. doi: 10.1161/01.cir.38.4.746. [DOI] [PubMed] [Google Scholar]