Up to 7 years of follow-up after two-stage anatomic correction of simple transposition of the great arteries.

In 16 patients, constituting 100% of children followed for up to 7 years after two-stage anatomic correction of complete transposition of the great arteries, clinical and electrocardiographic data, as well as cardiac catheterization data in 12 patients, were analyzed. None of them has had signs or symptoms of coronary or myocardial insufficiency after an adaptation phase of 6 months after anatomic correction. Body weight normalized 3 to 6 months after anatomic correction, and was normal in most cases after 1 year. No atrioventricular conduction delays or arrhythmias definitely attributable to anatomic correction were observed. Peak systolic pressure in the right ventricle was slightly elevated in 10 of 12 patients studied due to residual pulmonary stenosis from the band site. End-diastolic and end-systolic volumes as well as ejection fraction and end-diastolic pressure of the right ventricle were normal. End-diastolic and end-systolic volumes of the left ventricle were elevated (p less than .01), while muscle volume, ejection fraction, and end-diastolic pressure were normal. The pulmonary root was distended during the banding stage and did not dilate as did the aortic root after anatomic correction. Patients with complete transposition of the great arteries up to 7 years after anatomic correction develop normally without atrioventricular conduction delays, arrhythmias, or signs of coronary and myocardial insufficiency. The enlarged aortic root does not seem to dilate. The reasons for elevated left ventricular volumes are not clear at the present time. Earlier operation may prevent these changes.