Cardiopulmonary exercise performance in adult survivors of the Mustard procedure

Most patients with the Mustard procedure are now adults. To date, however, there have been few reports on resting and exercise hemodynamics in a large population of adults with this circulation. The aim of this study is to de scribe such parameters in one of the largest and oldest populations of adul ts with the Mustard procedure. The database of the University of Toronto Co ngenital Cardiac Centre for Adults was examined to identify 84 adults with the Mustard procedure who have undergone cardiopulmonary exercise tests. Ma gnetic resonance imaging and echocardiography studies were obtained in orde r to assess right ventricular size, function and baseline hemodynamics. Pat ients achieved lower maximum uptake of oxygen, maximal heart rate, forced v iral capacity, forced expiratory volume in 1 second, and oxygen saturations at maximal exercise compared to a healthy population. Magnetic resonance i maging showed significantly different right ventricular ejection fractions between patients and controls. There were no effects of operative variables or preoperative hemodynamics on current exercise capacity. Patients after the Mustard procedure have subnormal exercise capacities. Factors such as c hronotropic incompetence, peripheral deconditioning, and impaired lung func tion may be responsible for these results.