Today instead of our usual Wednesday morning multidisciplinary conference ("multi-dis" for short), we had a case presentation and lecture by the scary-smart Chair of Pediatrics for MSU. This guy always manages to have the most interesting cases. These are stories that twist and turn in unexpected ways en route to weird zebra diagnoses. The Powerpoint slides tend to be punctuated with vacation pictures from all over the world, which is nice too.
TIL: The Mustard procedure is the older version of surgical repair for the congenital heart defect of transposition of the great arteries. This is when a child is born with the aorta and pulmonary artery switched. This is not compatible with life after the in utero blood circulation pathways close, so an emergent surgery needs to be done after birth.
Nowadays, the surgery simply consists of chopping the two vessels off at the top of the heart and swapping where they attach. The tricky bit is that the coronary arteries, which supply blood to the heart muscle itself, must be carefully repositioned. This is so difficult that before modern techniques were developed, surgeons would instead reroute the blood within the heart.
Think of a washing machine. Imagine that you accidentally hooked up the hot water to the cold input and the cold to the hot. Because of some goofiness with the hot water pipe, rather than switching the two hoses to where they should be, you instead opt to open up the washing machine and rig up a series of spouts and PVC pipe that directs the various temperature water to the right end point.
It's shocking that this worked, but it was both the standard of care and the only option for a long time.
That sounds rather scary! Glad it works!
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