Arterial switch operation for transposition of great arteries: late results in adult patients

Giancarlo Scognamiglio, Wei Li


Complete transposition of the great arteries (TGA) accounts

for 5% to 7% of congenital cardiac anomalies, and represents

the second most common cyanotic heart defect. Successful

surgery, allowing the majority of patients to survive to

adulthood, can either involve a physiologic or anatomic

“correction”. The former (i.e. atrial switch), introduced in

1958 by Senning and later modified by Mustard, corrects the

physiologic abnormality of the TGA by creating an atrial baffle

to direct the venous return to the contralateral atrioventricular

valve and ventricle. Although mid-term clinical results

are excellent, this procedure leaves the RV supporting the

systemic circulation. Hence, complications such as progressive

RV dysfunction, ensuing tricuspid regurgitation, frequent

arrhythmias, heart failure and early mortality may arise in the


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Copyright (c) 2015 Giancarlo Scognamiglio, Wei Li

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