Early Results with the Anatomical Correction of Transposition of the Great Arteries

Abstract

From November 1984 to April 1991, 38 children underwent an arterial switch operation for transposition of the great arteries (TGA). In 24 infants (mean age 8 days) TGA with intact ventricular septum was present, in 14 patients (mean age 75 days) TGA was combined with a ventricular septal defect (VSD). There were 11 in-hospital deaths with an overall mortality of 29%, mainly due to technical problems. Whereas the group TGA + VSD showed a mortality rate of 50%, simple TGA and the subgroup simple TGA younger than 14 days had a mortality rate of 16.7% and 17.4%, respectively. Mortality was not influenced by coronary artery morphology and age. In simple TGA, the data presented suggest that this operation can be performed with good short-term clinical results. Most children are asymptomatic and without medication at a mean follow-up time of 2.5 years; but as there are pathological postoperative findings in echocardiography, the long-term benefit remains a matter of concern. Considerable perioperative problems are present in cases of TGA + VSD so surgical management is more differentiated, including other options.