Dextro-transposition of the great arteries general features surgery


 * Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [mailto:psingh@perfuse.org]; ; Keri Shafer, M.D. [mailto:kshafer@bidmc.harvard.edu]; Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [mailto:kfeeney@perfuse.org]

Corrective Surgery
Arterial switch operations (ASO) are now-days preferred over Atrial switch procedures (Mustard and Senning Operations) because of the following reasons-
 * Arterial switch procedure are comparatively easier to perform
 * ASO have similar survival benefits compared to atrial switch procedure
 * Decreased risk of complications like arrhythmias and heart failure in ASO compared to atrial switch procedures
 * Decreased peri-operative mortality in ASO compared to atrial switch procedures

Salient features of surgery are

 * It is best to perform the ASO as early as possible in the children. Most infants undergo definitive repair within the first 2 weeks of life.
 * The type of surgical procedure done depends on the type of lesion the child has i.e. simple or complex transposition of the great arteries.
 * The general rules that are followed are-
 * Simple D-TGA (D-TGA without any associated lesion)- Arterial switch operation (ASO).
 * D-TGA plus ventricular septal defect-Arterial switch operation (ASO) and VSD closure.
 * D-TGA plus large VSD plus pulmonary stenosis - Rastelli procedure

Acknowledgements and Initial Contributors to Page
Leida Perez, M.D.