Improved neurological outcome following early anatomical correction of transposition of the great arteries

Clin Cardiol. 1992 Apr;15(4):275-9. doi: 10.1002/clc.4960150410.


The incidence of neurological residuals following anatomical correction of transposition of the great arteries (d-TGA) has not been described so far. Clinical examination, EEG recordings, and computed tomography (CT) scans were carried out in a consecutive series of 38 children with d-TGA surviving anatomic corrective surgery. The patients were classified into one of three groups according to the type of operation: 15 patients after two-stage approach (TSA) (Stage 1: pulmonary artery banding+aortopulmonary shunt; Stage 2: anatomic correction); 12 patients with primary anatomic correction within the first 2 weeks of life (early switch, ES); 11 patients with primary anatomic correction later in infancy (later switch, LS). In 26 patients (68%) we found no abnormalities on neurologic examination, CT scan, or EEG. Four patients suffered from spastic hemiplegia, 3 of these had cortical brain damage visible on CT scan, and 3 had focal epilepsy as well. In 2 otherwise clinical normal patients cortical infarction could be seen on a CT scan. Thus, in 5 cases (13% of 38 patients) cerebral infarcts were diagnosed by CT scan. The cortical vascular infarction was seen in 4 patients after TSA and in 1 after LS. In 6 patients we found other neurological abnormalities. Early anatomic correction in patients with d-TGA reduces the risk of cortical vascular infarction.

MeSH terms

  • Cerebrovascular Disorders / diagnosis
  • Cerebrovascular Disorders / epidemiology*
  • Child, Preschool
  • Developmental Disabilities / diagnosis
  • Developmental Disabilities / epidemiology*
  • Electroencephalography
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Nervous System Diseases / diagnosis
  • Nervous System Diseases / epidemiology*
  • Neurologic Examination
  • Time Factors
  • Tomography, X-Ray Computed
  • Transposition of Great Vessels / surgery*
  • Treatment Outcome