Natural History of Transposition of the Great Arteries

Abstract

The natural history of transposition of the great arteries between 1957 and 1964 is presented based on a total of 742 cases. The area of study was the State of California and included 290 cases from 14 selected hospital centers. It is clear that in this era of more successful surgery, no such study will ever again be possible. Of major importance has been a compilation of a life table so that present day cardiologists and surgeons, when evaluating whether surgery should be undertaken in a particular patient, can weigh the risk of the operative procedure against the expected number of years of life remaining if surgery is not done. For the whole group the age of death was as follows: by 1 week, 28.7%; by 1 month, 51.6%; and by 1 year, 89.3%. The average life expectancy at birth was 0.65 years; at 1 week of age, 0.87 years; at 1 month, 1.12 years; and at 1 year, 3.92 years. Associated lesions had a marked effect on prognosis. The life tables presented tell a more complete story, and the pertinent data are presented in detail. (See longer summary at end of paper for further information.)