Mustard repair

The Mustard repair is a technique to correct transposition of the great arteries (TGA), and involves:

  • resection of atrial septum
  • creation of an atrial baffle with pericardium (or rarely synthetic material) 1

Rationale

Transposition of the great arteries involves a discordance between the ventricles and their respective great arteries.

The Mustard repair is an attempt to correct this at the atrial level.

The Senning repair is functionally similar to the Mustard repair, but uses the atrial septum itself as a baffle, rather than using pericardium or synthetic material.

The arterial switch procedure is now more commonly used than either the Mustard or Senning repairs. It functionally provides an arterial rather than an atrial "switch" and anatomically corrects the abnormality. This is done partly to avoid the long-term complication of arrhythmia.

Complications

Stenosis of the baffle occurs in up to 13% of cases 2 and the extensive atrial incisions results in intra-atrial conduction delays and possible arrhythmias 3.


Congenital heart disease

There is more than one way to present the variety of congenital heart diseases. Whichever way they are categorised, it is helpful to have a working understanding of normal and fetal circulation, as well as an understanding of the segmental approach to imaging in congenital heart disease.

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