Even without surgery, the patients may develop atrioventricular dissociation or tachyarrhythmias. Sudden unexpected death associated with preexisting complete atrioventricular block can occur 7 . If the diagnosis is made before fetal viability, the option of pregnancy termination may be considered. A careful search for associated cardiac and extracardiac anomalies is recommended. Serial exams are indicated to monitor fetal growth, the development of hydrops and to detect fetal demise.
Early delivery offers no advantage except in case of hydrops.
Delivery in a tertiary care center where a pediatric cardiologist is immediately available is a must 1 . The appropriate medical and surgical treatment will depend upon the clinical manifestations of associated lesion, dysrhythmias, and conduction disturbances. Ventricular septal defect, pulmonary outflow tract obstruction and systemic atrioventricular valve insufficiency account for most open heart operations in patients with corrected transposition. Repair of the ventricular septal defect with a patch sutured on the left side of the septum is a technique now being used to avoid the atrioventricular conduction system which lies on the right side of the septum 7 . The pulmonary outflow tract obstructions easily corrected by conventional techniques are pulmonary valvular stenosis, pulmonary band, and sub-pulmonary redundant tissue.