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Ann Thorac Surg 1995;59:1007
© 1995 The Society of Thoracic Surgeons

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Invited Commentary

Director of Cardiology, Victorian Paediatric Cardiac Surgical Unit, Royal Children's Hospital, Flemington Rd, Parkville, Victoria, 3052 Australia

See also page 1005

This article reports 2 patients who underwent late arterial switch repair after a Mustard procedure performed in infancy, and in whom pulmonary venous obstruction with secondary pulmonary hypertension developed. Because the left ventricular pressure was high, it was not necessary to carry out preliminary pulmonary artery banding.

This is an interesting and novel approach to the management of patients with pulmonary venous obstruction after a Mustard procedure, and fits well with our philosophy of recommending conversion to an arterial switch for all patients who have undergone Senning or Mustard procedures, and who clearly require further revisional operations in whom conversion to an arterial switch is a feasible option-either as a one-stage or two-stage procedure. In these patients, the presence of well-maintained right ventricular function puts them into a different category from that of many patients who become symptomatic and need to be considered for further operation, which, if an arterial switch is not feasible, may well involve transplantation. The fact that the Mustard baffle can be removed in its entirety as part of the conversion to an arterial switch, likely makes it the most satisfactory long-term solution to the problem of pulmonary venous obstruction-which in 1 of the 2 patients described recurred despite two previous attempts at revision.

Related Article

Arterial Switch for Pulmonary Venous Obstruction Complicating Mustard Procedure

Peter L. de Jong, Ad J. J. C. Bogers, Maarten Witsenburg, and Egbert Bos
Ann. Thorac. Surg. 1995 59: 1005-1007. [Abstract] [Full Text]

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This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Wilkinson, J. L. Search for Related Content PubMed PubMed Citation Articles by Wilkinson, J. L. Related Collections Related Article