The Arterial Switch Procedure

Done in early infancy, the arterial switch procedure moves reversed great arteries to their correct locations. Cardiothoracic surgeons perform this open-heart operation to switch the improperly connected pulmonary artery and aorta back to the correct location. The arterial switch procedure may be used for transposition of the great arteries (TGA) or other forms of heart disease in which the great arteries are rotated incorrectly. 

Parents with an infant with transposition of the great arteries should locate a pediatric heart surgeon with extensive experience in performing the arterial switch procedure. Since 2000, surgeons at Children’s have performed more than 270 arterial switch procedures, with or without ventricular septal defects, with a 100 percent 30-day in-hospital survival rate in 2010. The Children’s Sibley Heart Center attracts regional and national referrals for arterial switch procedures.

Before the Procedure

Before this operation is performed to repair the defect, a palliative procedure may be done to improve the infant’s condition until he is strong enough for the procedure. An example is a cardiac catheterization to create a hole in the heart’s inner wall that will allow mixing of oxygen–rich and oxygen–poor blood. This is a temporary procedure to allow the time and stability needed to perform an arterial switch procedure.

After the Procedure

After the arterial switch procedure is performed on an infant, oxygen–poor blood from the body returns to the lungs. In addition, oxygen–rich blood from the lungs is sent back to the body.

Long-term follow-up care to monitor the heart is needed, but long-term outcomes are typically very good.

Outcomes at Children's

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