Severe superior vena caval syndrome after the Mustard repair in a patient with persistent left superior vena cava.

This report describes our experience with a 6-year-old girl with dextro-transposition of the great arteries and persistent left superior vena cava, who manifested severe superior vena caval syndrome following a Mustard repair. A direct end-to-end anastomosis of the left superior vena cava to the left atrial appendage, which formed part of the systemic venous atrium, was performed with excellent relief of the obstruction. The rationale for application of this method is discussed as an alternative to the use of cardiopulmonary bypass for intra-atrial baffle revision.