TRANSPOSITION OF THE GREAT-ARTERIES IN WESTERN SWEDEN 1964-83 - INCIDENCE, SURVIVAL, COMPLICATIONS AND MODES OF DEATH

The records of all children with simple (n = 73) and complex (ii = 35) transposition of the great arteries who were born in western Sweden d uring 1964-53 were studied. The incidence was 0.24/1000 births. The pr eoperative mortality decreased from 100%, in 1964, before palliation w as introduced, to 16% at the end of the study period. Sixty-six underw ent corrective procedures: 37 Mustard, 21 Senning, 3 arterial switch a nd 5 Rastelli operations. The perioperative mortality, which was 26% i n simple transposition and 75% in complex, did not decrease significan tly during the study period. Of 39 hospital survivors, eight Mustard a nd two Senning patients died late of baffle complications (I? = 2), su dden death (n = 6), pulmonary vascular disease (n = 1) and systemic ve ntricle dysfunction (II = 1). The cumulative 20-year survival was 32% in simple transposition and 17% in complex. In a pioneer population wi th transposition, long-term survival was unsatisfactory. This was caus ed by continuing high perioperative mortality and late deaths.