Two-Stage Surgical Treatment of Complete Transposition of the Great Vessels

Abstract

SINCE THE pulmonary circulation is isolated from the systemic circulation in patients with complete transposition of the great vessels, extrauterine survival depends upon the presence of intercommunications in the form of atrial septal defect, ventricular septal defect, or patent ductus arteriosus. Postnatal survival may be possible in the presence of such connections but hypoxemia usually threatens life during infancy. Prompt application of a palliative operation in seriously ill infants with transposition often results in survival and permits the performance of a corrective operation at an older age and under more favorable circumstances. This paper concerns our experience with a two-stage surgical approach for transposition of the great vessels in patients who required their initial operation during the first year of life. The palliative operation was creation of an interatrial septal defect or atrial septectomy and the definitive repair was venous transposition by atrial septoplasty. Technical Considerations The operation used most