title: Operative indication for corrective surgery in cases of complete transposition of the great arteries associated with large ventricular septal defect.
abstract: Among 23 patients with complete transposition of the great arteries (TGA) and large ventricular septal defect (VSD) who underwent corrective surgery, there were nine deaths (39 per cent). Since 1972, improvement in operative techniques, linked with increasing experience in postoperative care, has reduced the hospital mortality rate to 29 per cent (five deaths in 17 patients). Only one of these 23 patients had pulmonary artery banding prior to definitive repair. Analysis of the preoperative hemodynamic data suggests that complete surgical repair is not indicated for patients who have TGA and large VSD, without significant pulmonary stensosis, when the pulmonary arteriolar resistance is greater than 2,500 dynes-sec.-cm.-5 or the effective pulmonary flow index is less than 1.2 L. per minute per square meter of body surface area.
mesh_terms: D006348:Cardiac Surgical Procedures / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000601:surgery; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000601:surgery; D006345:Heart Septal Defects, Ventricular / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D011651:Pulmonary Artery; D014188:Transposition of Great Vessels / Q000601:surgery*; D014655:Vascular Resistance