MODIFIED ASWAN MUSTARD PROCEDURE FOR TRANSPOSITION alexrossano@yahoo.com

PE007

MODIFIED ASWAN MUSTARD PROCEDURE FOR TRANSPOSITION

4

Mexico

Poster Exhibition only

Transposition of the great arteries (TGA) is a congenital heart defect characterized by ventriculo-arterial discordance, causing parallel circulations and systemic hypoxia. The arterial switch operation (ASO) is preferred in neonates but is limited in late presenters due to left ventricular (LV) deconditioning. Alternative surgical approaches are needed, especially in resource-limited settings.

The Modified Aswan Mustard Procedure revisits the atrial switch using synthetic polytetrafluoroethylene (PTFE) baffles with fenestrations to physiologically reroute blood flow without requiring LV retraining. The technique focuses on minimizing suture lines and tailoring baffle design to individual anatomy.

Early outcomes show effective systemic oxygenation, reduced postoperative complications including baffle obstruction and arrhythmias, and stable right ventricular (RV) function as systemic ventricle. Functional status remained good, with lower mortality compared to late ASO cases.

This modified procedure is a feasible alternative for late-presenting TGA patients unsuitable for ASO. Its technical simplicity and adaptability make it valuable for centers with limited resources. Further research is needed to refine technique and long-term outcomes.