Simple d-transposition of the great arteries. Results of early balloon septotomy followed by two-stage surgical correction.

The follow-up of 44 patients with simple d-transposition of the great arteries is presented. All had balloon atrial septotomy shortly after birth. If an operation was needed at or before one year of age, atrial septectomy was carried out. Correction was done between the ages of 19 and 64 months. Of the 44 patients, 34 (77 per cent) are living and doing well (27 after the Mustard procedure), 3 (7 per cent) are lost to follow-up, and 7 (16 per cent) are dead. Death was due to technical problems during initial catheterization and balloon septotomy in 2 patients, occurred after septectomy in one (3 per cent), and after the Mustard procedure in one (4 per cent). There was one sudden inexplicable death in a 1 1/2-month-old patient, and 2 patients died with pulmonary vascular obstructive disease. Because of the relatively low over-all mortality and morbidity and the low surgical mortality rate for both palliation and correction, we believe that two-stage surgical correction of transposition of the great arteries is preferable to early one-stage correction in the infant.