Surgical management of congenitally corrected transposition of the great arteries

Abstract

From 1962 to 1990, we have experienced 12 patients with congenitally corrected transposition of the great arteries (CTGA). Associated cardiac defects were present in all cases, most frequently ventricular septal defect (100%), and pulmonary stenosis (67%), Palliative procedures were done in 5, corrective operations in 6. One patient underwent corrective procedure 27 years after palliation. The hospital mortality rate was 8% (1/12), and 1 late death (8%) was seen in this series. In most cases, we approached the defect through the mitral valve, and the deLeval method was very useful in placing stitches along the trabecular septum. AV conduction disturbance could be avoided in 5 of 6 patients who underwent the closure of ventricular septal defect. Pulmonary stenosis was relieved by valvotomy and/or infundibulectomy, or implantation of an extracardiac conduit according to their anatomy. Cardiac function of systemic ventricle (morphologic right ventricle) were well preserved in the case undergoing intracardiac repair and also in the palliative cases. Careful observation is needed in these cases.