Right Heart Failure in a Patient with Complete Transposition of the Great Arteries and Mustard Operation

arteries is a severe and potentially lethal form of congenital heart disease which consists of the origin of the aorta arising from the morphological right ventricle and that of the pulmonary artery from the morphological left ventricle. The usual clinical presentation is severe cyanosis during the first days of life and requires surgical management. The procedure of choice in the past was the atrial switch operation, which represents a rather palliative approach and is implicated with serious long-term complications. We are presenting a case of a 33year-old man with complete transpotition of the great arteries who had undergone Mustard operation during childhood. He was admitted with refractory ascites and peripheral edema. Case description The patient, a 33-year-old male, father of three children, presented severe central cyanosis at birth due to complete transposition of the great arteries. An urgent percutaneous atrial septostomy was performed stabilizing the patients’ condition. During the first year of life he underwent a Mustard operation (atrial switch). The intraatrial septum was resected and with the use of pericardial tissue (pericardial baffle) the flow of superior and inferior vena cava (SVC, IVC) was diverted through the mitral valve into the left ventricle (LV) and thence through pulmonary artery, while the pulmonary venous flow through the rest of the “common” atrium (called “pulmonary baffle”) was diverted through the tricuspid valve and the right ventricle (RV) to the aorta.