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Updated: Aug 10, 2026
Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Surgical management of transposition of the great arteries
Insights
This study reviewed 62 transposition of the great arteries surgeries, finding an 18% mortality rate. Improving surgical techniques, like using xenograft valves, can enhance survival for this complex congenital heart defect.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Congenital Heart Defects
Background:
- Transposition of the great arteries (TGA) is a critical congenital heart defect requiring surgical correction.
- Early surgical intervention is crucial for improving outcomes in neonates with TGA.
Purpose of the Study:
- To evaluate the outcomes of total corrective surgery for transposition of the great arteries.
- To identify factors influencing mortality in TGA patients undergoing surgical correction.
Main Methods:
- Retrospective review of 62 patients with TGA who underwent total corrective surgery between 1967 and October 1974.
- Analysis of patient demographics, surgical procedures, and causes of death.
Main Results:
- An overall hospital mortality rate of 18% (11 out of 62 patients) was observed.
- Mortality was higher in patients with ventricular septal defects and pulmonary stenosis.
- The Donovan-Rastelli procedure showed improved survival when a xenograft aortic valve was used.
Conclusions:
- Surgical correction of TGA has significant associated mortality, particularly in complex cases.
- High pulmonary vascular resistance is a major cause of death.
- Individualized treatment approaches and timely, thorough medical and surgical management are essential for survival in TGA patients.
Abstract:
Sixty-two patients with transposition of the great arteries, ranging in age from one week to thirty-five years, underwent total corrective surgery during a seven year period at Stanford University Hospital. Reported herein are the first pateint to undergo complete correction at out hospital and every subsequent patient until October 1974. Eleven patients died, an overall hospital mortality of 18 per cent. Two of thirty-two patients with transposition of the great arteries and intact ventricular septum died, one of pulmonary hypertension at seven days of age. Nine of thirty patients with transposition of the great arteries and ventricular septal defect with or without pulmonary stenosis died. Cause of death usually was high pulmonary vascular resistance. The Donovan-Rastelli procedure was performed in ten patients, with three deaths, but all patients survived when the inserted right ventricular outflow contained a xenograft aortic valve. Transposition of the great arteries in the first weeks of life must be considered on the individual merits of each case, but the combined medical and surgical approach must be both expedient and thorough if the patient is to survive.
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