Successful staged surgical repair using rapid pulmonary artery banding in a very-low-birth-weight premature infant who had d-transposition of the great arteries with an intact ventricular septum.

The arterial switch operation is the surgical correction of choice for patients born with d-transposition of the great arteries (d-TGA) and an intact ventricular septum. However, prematurity and very low birth weight present both technical and physiologic challenges to this approach. Furthermore, in the setting of d-TGA and an intact ventricular septum, delaying intervention results in deconditioning of the left ventricle, rendering the patient a poor candidate for the arterial switch operation. The report presents an infant born at 27 weeks gestation weighing 1.01 kg who as a newborn underwent a successful urgent balloon atrial septostomy, pulmonary artery banding, and a central shunt on day of life (DOL) 82 and the arterial switch operation on DOL 93.