Transposition of the Great Vessels — The arterial switch operation, the atrial switch operation, the coronaries

Transposition of the great arteries (TGA) is one of the more common congenital heart diseases, accounting for 5% to 7% of all congenital cardiac lesions. Patients are now treated with anatomical correction with the arterial switch operation. In these patients MR and CT assessment can be useful to assess ventricular function, valvular function, the branch pulmonary arteries, and increasingly the coronary arteries. Historically, there remain a group of TGA patients who were treated with the atrial switching—Mustard or Senning operations. These patients present different follow-up problems, with failing systemic right ventricles, venous pathway obstruction and baffle leaks. Again MR and CT imaging can provide accurate diagnostic and prognostic information in these patients. This review will provide a brief description of the surgical options for TGA, followed by a discussion of the currently available CT and MR techniques, and their clinical role in the preoperative, immediate and late post-operative periods.