The Atrial Baffle Operation for Transposition of the Great Arteries: A Review of 591 Reported Cases

A survey of the literature on 591 atrial baffle operations for transposition of the great arteries was undertaken, and it was found that the underlying anatomical type strongly influences the results of operation. The overall mortality when an atrial septal defect was present alone was less than 20%. In the presence of a ventricular septal defect and pulmonary stenosis, the prognosis was less favorable. The most immediate postoperative complication was dysrhythmia, followed by ventilation problems necessitating tracheostomy. Long-term complications occurred in 30% of the patients. These included venous obstruction from the baffle itself, dysrhythmia, and tricuspid insufficiency. The 1-month mortality rate with the atrial baffle operation was 23%; at 5 years it was 38%. The long-term results suggest that a new approach should be considered in the surgical management of transposition. The goal remains direct anatomical repair.