Palliative procedures for transposition of the great arteries.

Palliation in uncomplicated transposition of the great arteries is a matter of achieving increased intracardiac mixing. This can be done by surgical atrioseptectomy or by balloon atrioseptostomy. The latter technique has been proved to be a safe and effective procedure for long-term palliation. In the presence of complicating lesions adjustments of the pulmonary blood flow must be made. When the complicating lesion is a ventricular septal defect with increased pulmonary blood flow, pulmonary artery banding is often required. In the presence of severe pulmonic stenosis with a ventricular septal defect, aorticopulmonary shunting may be required. Judicious application of these palliative procedures has completely altered the outlook of the infant born with transposed great arteries, with or without complicating lesions.