Transposition of the great arteries: anatomy, physiology and surgical outcomes today.

PURPOSE OF REVIEW: Dextro-transposition of the great arteries (d-TGA) is a relatively common form of cyanotic congenital heart disease that is not typically associated with chromosomal abnormalities or extracardiac abnormalities. Most cases of d-TGA are prenatally diagnosed, but there are cases of postnatal diagnosis that may present with cyanosis, acidosis and circulatory collapse. It is important for the general practitioner to be familiar with this patient population, as they require continued monitoring for postsurgical complications following surgical repair.

RECENT FINDINGS: The arterial switch operation was introduced in 1975 and is the current surgical treatment for d-TGA. As patients with arterial switch operation reach mid to late adulthood, we continue to explore the best ways to screen for, and treat, coronary insufficiency. Additionally, we are working to understand more about neurodevelopmental outcomes in this population.

SUMMARY: Advancements in prenatal diagnosis and surgical management of d-TGA have led to excellent outcomes in pre and postoperative mortality. Patients should be screened after surgical repair for complications related to coronary insufficiency with routine cardiology follow up.