Use of a transvenous dual-chamber ICD after a mustard operation for d-transposition of the great vessels.

A 40-year-old man was admitted to our institution with mild heart failure symptoms, including palpitations and near syncope. Twenty-eight years earlier, he had undergone a Mustard operation to correct d-transposition of the great vessels. At the present admission, echocardiography revealed severe right (systemic) ventricular dysfunction. Continuous monitoring also showed sinus-node dysfunction, sinus bradycardia, and nonsustained ventricular tachycardia. The patient underwent successful transvenous placement of a dual-chamber implantable cardioverter-defibrillator for pacing of the atria and prevention of sudden cardiac death. To our knowledge, there have been no previous reports of transvenous placement of an implantable cardioverter-defibrillator after surgery for d-transposition of the great vessels in the English-language medical literature.