Treatment of complete transposition of the great vessels with the Blalock-Hanlon operation.

TRANSPOSITION of the great vessels is not a rare anomaly. It accounts for 8 per cent and is the fourth most common of all congenital heart diseases, being surpassed in frequency only by patent ductus arteriosus, ventricular septal defect, and tetralogy of Fallot.' Furthermore, transposition is a notorious first cause of death from congenital heart disease in childhood. At the Texas Children 's Hospital transposition of the great vessels is the most frequent congenital heart malformation found at autopsy, accounting for 64 (21 per cent) of the 300 deaths from congenital heart disease. The high mortality from transposition of the great vessels is not usually due to a delay in diagnosis, since the most prominent symptoms, cyanosis, dyspnea, and growth failure usually cause the parents to seek medical help early. Nor is it due to difficulty in diagnosis, which according to Taussig2 can usually be made clinically with the help of an electrocardiogram and a roentgenogram, although confirmation by angiocardiogram is often desirable. The prognosis of this disease is so grave that the great majority of cases do not survive beyond the first year of life and only the occasional case survives to adolescence or adult life. Blalock and Hanlon3 found an average life expectancy of 19 months in 123 cases, and if one excludes six of their patients who lived 10 years or longer, the average duration of life was only 511⁄22 months. Keith and co-workers4 reported that 52 per cent of infants with