Atrial Baffles for the Treatment of Transposition of the Great Arteries (Mustard, Senning)

Abstract

The first attempt to repair a patient with transposition of the great arteries (TGA) was performed by Senning who successfully constructed an atrial baffle in 1958 [1]. The procedure employed an atrial baffle created from autologous tissue to redirect caval blood to the left atrium which emptied into the left ventricle which then pumped the deoxygenated blood to the lungs. Pulmonary venous blood was redirected to the morphologic right atrium and through the tricuspid valve into the right ventricle which then filled the aorta with oxygenated blood. Subsequently, in 1964, Mustard introduced an atrial switch procedure utilizing prosthetic patch material to create an intra-atrial baffle (Figs. 23.1 and 23.2) [2, 3]. See Fig. 19.22 for a diagram of the uncorrected circulation and the circulation after the atrial switch procedure which normalizes the blood flow circuit.