A newborn with d-Transposition of Great Arteries (d-TGA) and an intact ventricular septum presents with severe cyanosis (SpO2 52%) within hours of birth. Prostaglandin E1 infusion is started. The definitive anatomical correction performed in the neonatal period is:

• A Jatene arterial switch operation ✓
• B Mustard procedure (atrial baffle repair)
• C Rastelli procedure
• D Glenn shunt followed by Fontan completion

Explanation

The Jatene arterial switch operation (ASO) is the definitive repair for d-TGA, ideally performed in the first 2–3 weeks of life before the left ventricle involutes from lower pulmonary pressures. It involves transecting and switching the aorta and pulmonary artery to their correct ventricles and reimplanting the coronary arteries. The Mustard and Senning procedures are atrial-level corrections that redirect blood but leave the morphological right ventricle as the systemic ventricle, leading to late RV failure — no longer the preferred approach. The Rastelli is for TGA with VSD and pulmonary stenosis.

Reference: Ghai Essential Pediatrics, 10th ed.

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Written and medically reviewed by the StethoPrep medical team.