Complete anatomic correction of transposition of the great arteries (TGA) and ventricular septal defect (VSD) was performed on 2 infants with high pulmonary arterial resistance. Both patients were operated upon under deep surface-induced hypothermia and limited cardiopulmonary bypass. Direct repair of the anomaly was accomplished by switching the aorta and the pulmonary artery with reattachment of the coronary arteries. The clinical result in the 1st patient was satisfactory. The postoperative cardiac catheterization and angiogram demonstrated no gradient across either outflow tract and normal arrangement of the great vessels. The 2nd patient died in the operating room, probably due to compression or kinking of the left coronary artery.