Dextro-transposition of the great arteries general features surgery

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Cafer Zorkun, M.D., Ph.D. [3]; Keri Shafer, M.D. [4]; Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [5]

Overview

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

References

Acknowledgements and Initial Contributors to Page

Leida Perez, M.D.

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