Twenty-five Year Follow-up of the Operated D-transposition of the Great Arteries with Mustard Procedure: A Case Report
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Case Report

Twenty-five Year Follow-up of the Operated D-transposition of the Great Arteries with Mustard Procedure: A Case Report

Bull Cardiovasc Acad 2024;2(3):100-102 DOI: 10.4274/kvbulten.galenos.2024.08208
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Abstract

Transposition of the great arteries (TGA) is a rare congenital heart defect incompatible with life without surgical correction. This report presents a 25-year-old male patient who underwent the Mustard procedure for d-TGA in the neonatal period. The patient presented with chest discomfort, exertional dyspnea, and fatigue. A grade II/VI pansystolic murmur was noted, and investigations revealed right ventricular hypertrophy, mild cardiomegaly, and moderate pulmonary venous baffle obstruction (mean gradient: 14 mmHg). Treatment with carvedilol and aspirin was initiated, and the patient is followed up biannually. TGA involves ventriculo-arterial discordance, corrected with arterial switch or Mustard procedures. Adults surviving the Mustard procedure remain at risk of early death, heart failure, and arrhythmias. This case highlights the 25-year follow-up of a stable d-TGA patient after the Mustard procedure, emphasizing the importance of regular monitoring for long-term outcomes.

Keywords: Transposition of the great arteries, mustard, congenital heart disease

References

1

Vouhé P. Transposition des gros vaisseaux. Une malformation congenitale curable? [Transposition of the great arteries: a curable congenital heart defect?]. Rev Prat. 2012;62(3):305-308.

2

Pexieder T, Blanc O, Pelouch V, Ostàdalovà I, Milerovà M, Ostàdal B. Late fetal development of retinoic acid-induced transposition of great arteries: morphology, physiology, and biochemistry. In: Clark EB, Markwald RR, Takao A, editors. Developmental Mechanism of Heart Disease. Armonk, NY: Futura Publishing. 1995:297-307.

3

Ferencz C, Brenner JI, Loffredo C, Kappetein AP, Wilson PD. Transposition of great arteries: etiologic distinctions of outflow tract defects in a case-control study of risk factors. In: Clark EB, Markwald RR, Takao A. editors. Developmental Mechanism of Heart Disease. Armonk, NY: Futura Publishing. 1995:639-653.

4

Ladouceur M, Ruperti-Repilado FJ, Rutz T. Arterial switch operation: A surgical triumph with long-term management challenges. International Journal of Cardiology Congenital Heart Disease. 2024;15:100487.

5

Gallotti RG, Madnawat H, Shannon KM, Aboulhosn JA, Nik-Ahd F, Moore JP. Mechanisms and predictors of recurrent tachycardia after catheter ablation for d-transposition of the great arteries after the Mustard or Senning operation. Heart Rhythm. 2017;14(3):350-356.