Arterial switch operation (ASO) is the procedure of choice for anatomic correction of transposition of the great arteries (TGA) with or without minor or major associated anomalies. In infants older than 21 days of age, left ventricular (LV) retraining followed shortly by ASO represents a good alternative to primary ASO for patients with TGA and intact ventricular septum (IVS). There are some instances, like social situations in developing countries, in which babies with TGA don’t reach a cardiac center on time.

Our short experience is represented by 2 patients who underwent rapid 2-stage ASO. LV geometry, LV mass index, mass/volume ratio, LV diastolic posterior wall thickness/LV diastolic diameter ratio and the presence of a ductus arteriosus were considered on preoperative echocardiogram, as well as the LV mass.

Patient 1. Female. 2 months old. Diagnosis was TGA with IVS. A 4 mm MBTS together with a pulmonary artery banding (PAB) were made. ASO was performed after 6 days. Follow-up is 10 months. Good ventricular and valvar function was seen on Echocardiographic examination.

Patient 2. Female. 4 months old, underwent a 4 mm MBTS associated with a PAB. The pos operative course was complicated by sepsis. Eventually she had an ASO after 22 days. Follow-up is 4 months, with good ventricular and valvar performance.

A number of patients in our area cannot reach a primary cardiac center on time. In patients with TGA and IVS, when LV mass/volume ratio<1.5, we consider rapid 2-stage ASO, with encouraging results.