Avoiding Postoperative Dysrhythmias and Venous Obstruction Following Mustard's Operation: Technical Considerations

Abstract

Five infants with uncomplicated transposition of the great arteries underwent correction during which special care was taken to avoid unfavorable hemodynamic and rhythm abnormalities. The late rhythm was sinus in all but 1 patient, who developed atrial flutter three years after operation; the flutter was converted to sinus bradyarrhythmia with dc countershock. Intracardiac electrograms showed normal sinus node function and normal intraatrial conduction despite division of the posterior internodal tracts. Cardiac catheterization done in 3 patients one to three years after operation showed widely patent channels into the systemic venous atria, and contractility studies demonstrated that the right ventricle functioned well as a systemic pump.