Surgical management of transposition with ventricular septal defect and obstruction to the left ventricular outflow tract

Extract

The arterial switch operation has become the preferred surgical procedure for the management of simple and complex transposition, defined on the basis of concordant atrioventricular but discordant ventriculo-arterial connections, with excellent results over the short-term, and thus far over the long-term. When transposition is associated with a ventricular septal defect, and there is additional obstruction within the left ventricular outflow tract, the complexity of the surgical repair is increased, and the surgical options are not as attractive.