J.Jpn. Surg. Soc.. 83(9): 936-939, 1982

---

Report on the annual meeting

PREVENTION OF ARRHYTHMIA SECONDARY TO MUSTARD PROCEDURE FOR TRANSPOSITION OF THE GREAT ARTERIES

One of the major complications following Mustard procedure has been the high incidence of arrhythmia. In this procedure, injury to three specific internordal paths demonstrated by James are unavoidable by atrial incision and baffle sutures. We have interpreted internodal conduction may not solely depended on these specific internodal paths and may be maintained, if the continuity of undamaged atrial muscle between S-A node and A-V node remained intract. This is the limited pathway (we call “noble zone”) between both nodes via right atrium, atrial septum, left artium and atrial septum near the atrioventricular ring. The modified “Mustard procedure”, to protect S-A node, its blood supply, A-V node and this “noble zone”, has been performed in 18 patients with transposition of the great arteries. All of them maintained sinus rhythm in early postoperative period and twelve of 13 survived patients (92.3%) have been showing sinus rhythm in late follow-up period.
These results justify our concept concerning to internodal conduction and suggested that arrhythmia secondary to Mustard procedure can be surgically avoided.

---

---

To read the PDF file you will need Adobe Reader installed on your computer.