Great-vessel switch operation without coronary relocation for transposition of great arteries

Since its first successful clinical application in 1963, the Mustard operation has been the procedure of choice for most patients with transposition of the great arteries. Based on the principle of transposition of venous return, it produces a functional but not anatomic correction of the defect. Although the Mustard procedure has favorably changed the natural history of transposition, it is associated with various early and late complications that have led to a search for a more anatomic repair. Recently, transposition has been successfully corrected by switching the great vessels, with or without transplanting the coronary arteries. These are the first case reports of early postoperative hemodynamics in patients undergoing an arterial switch procedure without coronary relocation. The early hemodynamic and clinical results of this operation are excellent and they lend encouragement for its further application in suitable patients.