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Myocardial infarction late after Mustard procedure

E C Kirkpatrick1, R Hurwitz

  • 1James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, 702 Barnhill Drive, Indianapolis, IN 46202, USA.

Pediatric Cardiology
|November 27, 2004
PubMed

Insights

Patients with d-transposition of the great arteries after a Mustard procedure face a risk of coronary embolism and myocardial infarction. A mural thrombus in the systemic ventricle was identified as a likely cause in this case report.

Area of Science:

  • Cardiology
  • Congenital Heart Disease
  • Cardiac Surgery

Background:

  • D-transposition of the great arteries (dTGA) is a complex congenital heart defect.
  • The Mustard procedure is a palliative surgical intervention for dTGA.
  • Long-term complications following palliative cardiac surgery require ongoing investigation.

Observation:

  • A young male patient with a history of Mustard procedure for dTGA presented with recurrent myocardial infarctions.
  • Cardiac imaging revealed a mural thrombus within the systemic ventricle.
  • Coronary embolism was identified as the etiology for the myocardial infarctions.

Findings:

  • The mural thrombus served as a probable nidus for coronary embolism.
  • Patients undergoing the Mustard procedure are identified as a population at risk for coronary embolization.
  • Coronary embolism can manifest as myocardial infarction in the late post-operative period.

Implications:

  • This case highlights a significant, potentially life-threatening complication in Mustard procedure survivors.
  • Awareness of coronary embolism risk is crucial for the long-term management of dTGA patients.
  • Timely diagnosis and management of embolic events may prevent adverse outcomes, including sudden cardiac death.

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