Prognosis of children with transposition of the great arteries, treated in a regional heart centre between 1967 and 1979

In an attempt to assess the changing prognosis of babies with transposition of the great arteries, the clinical data of 121 children diagnosed between January 1967 and December 1979 were reviewed. One hundred and four patients initially had balloon atrial septostomy; in 34 infants palliative operations (resection of ductus or coarctation, banding of the pulmonary artery or aortic-pulmonary anastomosis) were needed. Corrective surgery was performed according to the techniques of Mustard (43 patients), Senning (seven patients), Rastelli (five patients), or as an anatomic correction (two patients). While 80% of the infants survived the first month of life, 25% died between then and corrective surgery. The mortality of the intra-atrial operations decreased from 28% before 1976 to 12% subsequently. Postoperative cardiac rhythm disturbances occurred in 39.4% of the children after Mustard's operation, hemodynamic complications in 24.2%. Neurological complications developed more frequently in children with simple transposition (27.3%) than in children with complex transposition (18.2%). As a result of improvement in therapeutic and surgical regimens, the two-year survival rate showed a clear trend of increase from 48.5% between 1967–70 to 62.5% between 1977–79.