Simple Transposition

The aorta rises from the right ventricle, and the pulmonary artery from the left ventricle. Blue, relatively deoxygenated blood is thus directed back to the body and pink oxygenated blood from the lungs is directed back into the lungs.

These children present early in life with ‘blueness’ (cyanosis). Usually a hole is made between the two receiving chambers of the heart using a procedure with a special catheter – a balloon septostomy, allowing the two blood streams to mix.

The operation which is now preferred is an ‘arterial switch’ to put the arteries back onto their normal ventricles, at the same time re-implanting the coronary arteries. This needs to be carried out in the first weeks of life while the left ventricle is still relatively thick walled. It is a large, open heart operation. Occasionally, a different operation redirecting the blood flow throughout the atrium, the Senning or Mustard procedure, is advised and this may be deferred until later in the first year of life. These were the operations that were most commonly performed until the late 1980s. In them, the left ventricle continue to pump blood to the lungs with the right ventricle pumping to the body.

The majority of children with both types operation are very well afterwards and enjoy all normal activities.

Long-term follow-up is required and possibly antibiotic prophylaxis, but if the circulations are working well, it may not be necessary.

Simple Transposition of Great Arteries

Victoria & Tasmania