Causes of preoperative mortality in transposition of the great arteries: 2cases.

The prognosis of transposition of the great arteries improved tremendously with the development of an early medico-surgical strategy including balloon atrioseptostomy, prostaglandin infusion and the arterial switch operation within the first days of life. Nevertheless, some patients still die preope ratively. We report on two newborn infants whose fatal outcome was promoted by an ina dequate intercirculatory mixing. Since the diagnosis was not immediately ma de, the restrictive foremen ovale resulted very quickly in deep metabolic a cidosis and balloon atrioseptostomy performed yet in the first hours of lif e could not prevent death. We emphasize the importance of prenatal echographic detection of this defec t, only way to plan a balloon septostomy immediately after delivery in thos e infants suffering from inadequate atrial mixing.