Dextro-transposition of the great arteries (D-TGA) has undergone a significant evolution in surgical repair, leading to survivors with vastly different postsurgical anatomy which in turn guides their long-term cardiovascular morbidity and mortality. Atrial switch repair survivors are limited by a right ventricle in the systemic position, arrhythmia and atrial baffles prone to obstruction or leak. Functional assessment of the systemic right ventricle is complex, requiring multimodality imaging to include specialised echocardiography and cross-sectional imaging (MRI and CT). In the current era, most neonates undergo the arterial switch operation with increasing understanding of near-term and long-term outcomes specific to their cardiac anatomy. Long-term observations of the Lecompte manoeuvre or coronary stenoses following transfer continue, with evolving understanding to improve surveillance. Ultimately, an understanding of postsurgical anatomy, specialised imaging techniques and interventional and electrophysiological procedures is essential to comprehensive care of D-TGA survivors.

中文翻译：

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成人大动脉手术改良 d 转位的管理注意事项

大动脉右旋转位 (D-TGA) 在手术修复中发生了重大变化，导致幸存者术后解剖结构大不相同，这反过来又指导了他们的长期心血管发病率和死亡率。心房开关修复幸存者受到全身位置右心室、心律失常和心房挡板容易阻塞或泄漏的限制。全身性右心室的功能评估很复杂，需要多模态成像，包括专门的超声心动图和横断面成像（MRI 和 CT）。在当前时代，随着对特定于心脏解剖结构的近期和远期结果的了解越来越多，大多数新生儿都接受了动脉转换手术。转移后对 Lecompte 操作或冠状动脉狭窄的长期观察继续，随着不断发展的理解，以改善监测。最终，了解术后解剖结构、专业成像技术以及介入和电生理程序对于 D-TGA 幸存者的全面护理至关重要。