Clinical experience with atrial inversion using a Gore-Tex baffle in 52 cases of transposition of the great arteries

Atrial inversion was achieved by a modified Mustard operation in 334 patients with various types of transposition of the great arteries (TGA) between January, 1974, and January, 1983, in Hannover, West Germany. The overall mortality was 4.2% (N = 14). Between March, 1978, and January, 1983, 197 of the patients were operated on using a new design of a Gore-Tex prosthetic baffle. In February, 1982, a new step was integrated into our modification of the Mustard operation. It consisted of creating a pericardial flap that serves to enlarge the pulmonary venous atrium. This article describes the modified Mustard operations with Gore-Tex baffle used in 52 children with TGA between October, 1981, and January, 1983. Special attention is focused on operative techniques and on postoperative dysrhythmias and hemodynamics.