Repair of intracardiac defects associated with congenitally corrected transposition of the great arteries.
From October 1976 to June 1986, 12 patients with corrected transposition of the great arteries (c-TGA) underwent repair of associated intracardiac defects. Ventricular septal defect (VSD) was closed by the method of de Leval in 7 patients, pulmonary outflow tract obstruction was relieved by valvotomy in 2, and bypassed by an external valved conduit in 6. The systemic atrioventricular (A-V) valve was replaced in 2. There was one operative death, giving a mortality rate of 8%. None of the patients developed complete heart block. The ejection fraction of the systemic ventricle was impaired (29-38%), particularly after ventriculotomy of this chamber. Surgical repair of intracardiac defects associated with c-TGA currently can be performed with acceptable risk, and de Leval's method for VSD closure is recommended; but the possibility of the postoperative development of systemic ventricular dysfunction and A-V valve regurgitation necessitates careful follow-up.