LATE POSTOPERATIVE HEMODYNAMIC RESULTS AND CINEANGIOCARDIOGRAPHIC FINDINGS AFTER MUSTARD ATRIAL BAFFLE REPAIR FOR TRANSPOSITION OF GREAT ARTERIES

Patients (49) with transposition of the great arteries who underwent a Mustard atrial baffle repair between 1964-1971 were assessed late postoperatively. There were 5 late deaths: 2 related to baffle obstruction, 2 from noncardiac causes, and 1 sudden and unexpected. Hemodynamic data were available in 42 patients and autopsy in 4. Obstruction of the lower venous channel was not encountered. Patients (3) had severe obstruction of the upper venous channel and in 4 there was mild restriction. Patients (2) had severe pulmonary venous obstruction resulting in late death; mild asymptomatic obstruction could not be excluded with certainty in 6 patients. Tricuspid incompetence was infrequently encountered in patients with an essentially intact ventricular septum. Left ventricular outflow tract obstruction was found in 8 patients. In 3 it was present after satisfactory but incomplete surgical relief and in 5 it was not recognized prior to operation. In only 1 of the latter patients was the obstruction important. Patients (17) were operated on prior to 1 yr of age. While baffle obstruction was confined almost entirely to these patients, the 5 youngest patients, aged 1-9 wk at operation, had adequate pulmonary and caval compartments at restudy 2-3 yr later.