THE CHANGING STRATEGIES IN OPERATION FOR TRANSPOSITION OF THE GREAT-VESSELS

Between July 3, 1985, and February 24, 1994 a total of 55 infants unde rwent arterial switch procedures for the repair of transposition of th e great vessels. Thirty-five infants had an intact ventricular septum and 20 had ventricular septal defects. To date, there have been three late deaths, one in the group with an intact ventricular septum and tw o in the group with a ventricular septal defect. Early postoperative c omplications included atrial dysrhythmias, prolonged ventilation, inab ility to close the sternum, and tension on the coronary arteries. Foll ow-up echocardiographic data for 44 patients indicate that pulmonary a rtery gradients are a worrisome postoperative problem, especially in i nfants who have ventricular septal defects.