Double-switch procedure – Mustard atrial switch, arterial switch and ventricular septal defect closure

The double-switch operation, which combines atrial and arterial switch procedures, provides the best anatomical repair for congenitally corrected transposition of the great arteries [1]. The available atrial switch options are the Senning and Mustard procedures. The Senning operation, which mainly uses native tissue, is performed more frequently [2]. The Mustard operation, by contrast, requires excision of the interatrial septum and insertion of a heterogeneous baffle to achieve the atrial switch [3,4]. Surgical videos showing a double-switch operation with a Mustard atrial switch are limited. This video tutorial demonstrates the technique of double-switch repair using a native pericardial Mustard atrial switch, along with ventricular septal defect closure and arterial switch operation, in a 3-year-old child with corrected transposition of the great arteries, ventricular septal defect and subpulmonary obstruction.