ARTERIAL SWITCH

A relatively large spectra of anatomic variations are found within the unifying features of discordant ventriculoarterial connections. Varia nts that lend themselves to anatomic repair by the arterial switch ope ration are discussed, these include transposition of the great arterie s with intact ventricular septum (TGA TVS), TGA associated with a vent ricular septal defect (TGA VSD), double-outlet right ventricle with su bpulmonary VSD (DORV VSD), and TGA or DORV with VSD associated with co arctation. Double discordance with VSD, which is currently treated by double switch or Rastelli and atrial switch and which probably represe nts, in our department, the only remaining indication for atrial switc h, is not discussed. Also, we exclude TGA associated with pulmonary st enosis, which is treated by Rastelli or REV operation.