Mustard procedure
Encyclopedia
The Mustard procedure was developed in 1963 by Dr. William Mustard
at the Hospital for Sick Children
in Toronto
, Canada
.
Dr. Mustard, with support from the Heart and Stroke Foundation of Canada
, developed the first operation to correct a congenital heart defect that produced “blue babies”. The defect is called transposition of the great vessels
. The condition was common and fatal. The defect causes blood from the lung
s to flow back to the lungs and blood from the body to flow back to the body. This occurs because the aorta
and the pulmonary artery
, the two major arteries coming out of the heart, are connected to the wrong chambers. The babies look blue because there is insufficient oxygen circulating in their bodies.
The Mustard Procedure allows total correction of transposition of the great vessels. The procedure employs a baffle
to redirect caval blood flow to the left atrium which then pumps blood to the left ventricle which then pumps the deoxygenated blood to the lungs.
In a normal heart, de-oxygenated blood is pumped into the lungs via the right ventricle. Then it is distributed throughout the body via the left ventricle. In the Mustard procedure, blood is pumped to the lungs via the left ventricle and disseminated throughout the body via the right ventricle.
The Mustard procedure improved an 80% mortality rate
in the first year of life to an 80% survival at age 20.
The Mustard procedure was largely replaced in the late 1980s by the Jatene procedure
(arterial switch), in which the native arteries were switched back to normal flow, so that the RV (right ventricle) would be connected to the pulmonary artery and the LV (left ventricle) would be connected to the aorta. This surgery had not been possible prior to 1985 because of difficulty with re-implanting coronary arteries which perfuse the actual heart muscle itself (myocardium).
William Mustard
William Thornton Mustard, was a Canadian physician and cardiac surgeon. In 1949, he was one of the first to perform open-heart surgery using a mechanical heart pump and biological lung on a dog at the Banting Institute...
at the Hospital for Sick Children
Hospital for Sick Children
The Hospital for Sick Children – is a major paediatric centre for the Greater Toronto Area, serving patients up to age 18. Located on University Avenue in Downtown Toronto, SickKids is part of the city’s Discovery District, a critical mass of scientists and entrepreneurs who are focused on...
in Toronto
Toronto
Toronto is the provincial capital of Ontario and the largest city in Canada. It is located in Southern Ontario on the northwestern shore of Lake Ontario. A relatively modern city, Toronto's history dates back to the late-18th century, when its land was first purchased by the British monarchy from...
, Canada
Canada
Canada is a North American country consisting of ten provinces and three territories. Located in the northern part of the continent, it extends from the Atlantic Ocean in the east to the Pacific Ocean in the west, and northward into the Arctic Ocean...
.
Dr. Mustard, with support from the Heart and Stroke Foundation of Canada
Heart and Stroke Foundation of Canada
The Heart and Stroke Foundation of Canada is a registered Canadian charity. The foundation's purpose is centered around educating individuals about the prevention and management of heart disease and stroke, and to fund medical research regarding the causes of these conditions...
, developed the first operation to correct a congenital heart defect that produced “blue babies”. The defect is called transposition of the great vessels
Transposition of the great vessels
Transposition of the great vessels is a group of congenital heart defects involving an abnormal spatial arrangement of any of the primary blood vessels: superior and/or inferior vena cavae , pulmonary artery, pulmonary veins, and aorta...
. The condition was common and fatal. The defect causes blood from the lung
Lung
The lung is the essential respiration organ in many air-breathing animals, including most tetrapods, a few fish and a few snails. In mammals and the more complex life forms, the two lungs are located near the backbone on either side of the heart...
s to flow back to the lungs and blood from the body to flow back to the body. This occurs because the aorta
Aorta
The aorta is the largest artery in the body, originating from the left ventricle of the heart and extending down to the abdomen, where it branches off into two smaller arteries...
and the pulmonary artery
Pulmonary artery
The pulmonary arteries carry deoxygenated blood from the heart to the lungs. They are the only arteries that carry deoxygenated blood....
, the two major arteries coming out of the heart, are connected to the wrong chambers. The babies look blue because there is insufficient oxygen circulating in their bodies.
The Mustard Procedure allows total correction of transposition of the great vessels. The procedure employs a baffle
Baffle (medical)
A baffle is a tunnel or wall artificially constructed within the heart or great vessels for the purpose of redirecting blood flow in cases of congenital heart defects....
to redirect caval blood flow to the left atrium which then pumps blood to the left ventricle which then pumps the deoxygenated blood to the lungs.
In a normal heart, de-oxygenated blood is pumped into the lungs via the right ventricle. Then it is distributed throughout the body via the left ventricle. In the Mustard procedure, blood is pumped to the lungs via the left ventricle and disseminated throughout the body via the right ventricle.
The Mustard procedure improved an 80% mortality rate
Mortality rate
Mortality rate is a measure of the number of deaths in a population, scaled to the size of that population, per unit time...
in the first year of life to an 80% survival at age 20.
See also
- Congenital heart disease
The Mustard procedure was largely replaced in the late 1980s by the Jatene procedure
Jatene procedure
The Jatene procedure, or arterial switch, is an open heart surgical procedure used to correct dextro-transposition of the great arteries ; its development was pioneered by Canadian cardiac surgeon William Mustard and it was named for Brazilian cardiac surgeon Adib Jatene, who was the first to use...
(arterial switch), in which the native arteries were switched back to normal flow, so that the RV (right ventricle) would be connected to the pulmonary artery and the LV (left ventricle) would be connected to the aorta. This surgery had not been possible prior to 1985 because of difficulty with re-implanting coronary arteries which perfuse the actual heart muscle itself (myocardium).