ABSTRACT

Anatomical repair, by restoring ventriculoarterial concordance, offers the optimal long-term survival to patients born with transposition of the great arteries. The arterial switch operation (ASO) has become, with time, a simplified and safe operation, with an operative mortality approaching 0%.1 Almost all technical problems raised by an abnormal coronary artery anatomy and by associated cardiac lesions have found adapted solutions. The aim of this chapter is to describe the current surgical technique and some useful “tricks” adopted during a 25-year experience with this operation. This chapter focuses on management of transposition of the great arteries with intact ventricular septum (TGAIVS) and describes the anatomical classification of coronary arteries and the technique of coronary transfer in complex anatomy.