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ORIGINAL ARTICLE

Mustard operation for surgical treatment of simple transposition of the great arteries

Cláudio A GomesI; Jorge Vieira RodriguesI; Fernando Moraes NetoI; Cleuza Lapa SantosI; Sandra MattosI; Carlos R MoraesI

DOI: 10.1590/S0102-76381995000300004

ABSTRACT

Between April of 1975 and January of 1994, 28 patients underwent correction of simple transposition of the great arteries by a modification of the Mustard operation, designed to avoid dysrhythmias and to minimize systemic and pulmonary venous obstruction. Age ranged from 21 days to 7 years (mean age 18 months). The majority (22 patients) were in the first year of life. Early mortality occurred in 6 patients. Four of the early deaths were in children younger than 4 months. Among the 22 survivors no serious dysrhythmias or right ventricular dysfunction were detected. Three patients presented superior vena cava (2) and pulmonary (1) venous obstruction, and were easily managed at reoperation. Current results with the modified Mustard operation are good and this procedure is still an alternative in children with simple transposition who are not candidates for anatomical repair.

RESUMO

Entre abril de 1975 e janeiro de 1994, 28 crianças foram submetidas à operação de Mustard para tratamento da transposição simples das grandes artérias através de modificação técnica destinada a evitar arritimias e minimizar o problema da obstrução venosa sistêmica ou pulmonar. A idade variou de 21 dias a 7 anos (média, 18 meses). A maioria dos pacientes (22) estava no primeiro ano de vida. Ocorreram seis óbitos no período de internação hospitalar, quatro dos quais em crianças com menos de quatro meses de idade. Entre os 22 sobreviventes, não foram detectadas arritmias graves ou disfunção direita. Três pacientes foram reoperados com sucesso, para tratamento de obstrução venosa de veia cava superior (2 casos) e veias pulmonares (1 caso). Os resultados atuais da operação de Mustard modificada são bons, e este procedimento continua como alternativa válida em pacientes com transposição simples das grandes artérias não candidatos à correção anatômica.
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Article receive on Saturday, September 30, 1995

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