title: [The anatomical correction of transposition of the great arteries in the neonatal period].
abstract: OBJECTIVE
  Anatomic correction of transposition of the great arteries in simple and complex form is theoretically the only procedure which offers the possibility of real cure to the problem. We report there our operative results and mid-term follow-up with this approach.
  
  
  METHODS
  From June 1989 to February 1994, anatomical surgical correction was performed in 41 patients in the neonatal period, 31 with simple TGA and 9 patients with transposition associated with ventricular septal defect. We report our preoperative management, anatomic findings and surgical technique.
  
  
  RESULTS
  Our initial experience with the arterial repair was associated with a high operative mortality. The actuarial survival rate was 74% at 56 months. Hospital mortality of the last 31 patients was 12.9%. Intermediate-term follow-up was 18 months. No late deaths. One patient underwent reoperation for supravalvular pulmonary stenosis. All survivors are in functional class I. The only significant risk factor of in-hospital mortality was the time of surgery (learning curve).
  
  
  CONCLUSIONS
  The initial experience with arterial repair is associated with a difficult learning curve. Primary repair must be performed during the newborn period in simple and complex transpositions. Mid-term results are very encouraging. Longer follow-up is necessary to secure this technique and to render obsolete all other types of repair.
authors.affiliation: Sección de Cirugía Cardíaca Pediátrica, Hospital Infantil La Fe, Valencia.
authors.forename: J M
authors.initials: JM
authors.lastname: Caffarena Calvar
authors.forename: J M
authors.initials: JM
authors.lastname: Gómez Ullate
authors.forename: P
authors.initials: P
authors.lastname: Malo
authors.forename: J R
authors.initials: JR
authors.lastname: Mínguez
authors.forename: J I
authors.initials: JI
authors.lastname: Carrasco
authors.forename: E
authors.initials: E
authors.lastname: Tomás
authors.forename: E
authors.initials: E
authors.lastname: García
authors.forename: J M
authors.initials: JM
authors.lastname: Caffarena Raggio
mesh_terms: D001017:Aortic Coarctation / Q000401:mortality / Q000473:pathology / Q000601:surgery; D016009:Chi-Square Distribution; D005500:Follow-Up Studies; D006345:Heart Septal Defects, Ventricular / Q000401:mortality / Q000473:pathology / Q000601:surgery; D017052:Hospital Mortality; D006801:Humans; D007231:Infant, Newborn; D008722:Methods; D011300:Preoperative Care; D013030:Spain / Q000453:epidemiology; D016019:Survival Analysis; D014188:Transposition of Great Vessels / Q000401:mortality / Q000473:pathology / Q000601:surgery*