Corrected transposition of the great vessels associated with an obscured ventricular septal defect due to an abnormal systemic atrioventricular valve (report of a case and surgical considerations).

A case of corrected transposition associated with atrial septal defect, obscured ventricular septal defect, mild pulmonary valvar stenosis, severe systemic atrioventricular valve regurgitation and complete heart block is described. Closure of an atrial septal defect and a ventricular septal defect was carried out through a left atriotomy. Systemic atrioventricular valve replacement with a 27 mm. Hancock porcine valve was performed through the same approach. A permanent Demand rechargeable pulse generator unit with myocardial unipolar electrode lead was implanted. In the presence of complete heart block, a beating heart was not mandatory while repairing the ventricular septal defect. This enabled us to employ the hypothermic cardioplegic technique which greatly facilitated the surgical repair. Despite the multiplicity and magnitude of the anomalies, gratifying results were obtained. The surgical approach and technical precautions are discussed.