Repair of Transposition of the Great Arteries in 123 Pediatric Patients

Abstract

From May 1963 to July 1972, 123 patients ranging in age from 20 days to 15 years, with D-transposition of the great arteries, underwent an intraatrial baffle operation using a pericardial baffle. They previously had had a total of 121 various palliative procedures. Twenty-six children (21%) died in the early postoperative period. The operative mortality was 13% in transposition of the great arteries with intact ventricular septum, 45% in trasnposition of the great arteries plus ventricular septal defect, and 33% in transposition of the great arteries plus ventricular septal defect and left ventricular outflow tract obstruction. By contrast the overall mortality has decreased to 15% in the 72 patients operated upon over the last 2 years. There were 12 late deaths, 10 of which occurred within the first year postoperatively. Unexplained heart failure accounted for four deaths. Two sudden deaths were attributed to arrhythmias. Three patients died of proven pulmonary venous obstruction, one of them at reoperation. Pulmonary hypertension, reoperation for detachment of the baffle, and hypoglycemia were each the cause of one late death. There were no proven cases of tricuspid incompetence. Eighty children have been repeatedly reexamined for up to 8 years and 6 months. The actuarial 6-year survival was 74.8% for survivors of operation. Seventy-three children were leading a normal life at the time of the report.