TREATMENT OF TRANSPOSITION OF THE GREAT-ARTERIES

Today, the arterial switch operation is the treatment of choice for pa tients with transposition of the great arteries. Midterm follow-up con firms the initial hopes for good systemic ventricular function and lac k of arrhythmias. A two-stage operation can be performed in patients s een after 1 month of age or in subjects who have had an atrial switch operation and with late systemic dysfunction. Increasing experience wi th the arterial switch operation has led to its successful use in more complex lesions. increased mortality and morbidity after the atrial s witch operation has been confirmed, with decreased cardiac output, baf fle obstruction, and arrhythmias. In some cases interventional cathete rization is useful. In patients with corrected transposition of the gr eat arteries who have associated malformations, the poor midterm resul ts seen with the classical surgical repair make the combined atrial an d arterial switch an interesting option. (C) 1997 Rapid Science Publis hers.