Early experience with arterial repair of transposition

Major anomalies associated with isolated complete transposition of the great arteries (TGA) can produce systemic pressure in the left ventricle without fixed stenosis of the left ventricular outflow tract. In this situation, arterial repair may be advantageous. Eight children, 10 days to 15 years old, underwent arterial repair of TGA. Major associated anomalies included large patent ductus arteriosus, bulging intraventricular septum, ventricular septal defect (VSD), tricuspid atresia, and the Taussig-Bing type of double-outlet right ventricle. There were 2 operative deaths related to acute left ventricular failure. The survivors underwent postoperative echocardiographic, hemodynamic, and angiographic assessment; all were in sinus rhythm and well six months to 2 1/2 years after operation. Residual lesions have been frequent but mild: aortic insufficiency (5), stenosis of the right ventricular outflow tract (1), trivial VSD (1), and stenosis of the right coronary artery (1). Left ventricular function is "normal" in 4 and unchanged from moderately depressed preoperative status in 1.