Currently, arterial switch operation appears as a standard surgical management for patients under three weeks of age with transposition of the great arteries with an intact ventricular septum, while, beyond three weeks of age, there is no such standard approach and surgical procedures may vary among the health care centers. Low cardiac output and left ventricle failure may also develop after three weeks due to the progressive involution of left ventricle after arterial switch operation. Therefore, the Senning or Mustard procedure, or two-stage repair arterial switch operation are optional surgical management modalities in this patient population. However, due to the potential complications of these procedures in the short- and long-term, there has been an increased interest in performing primary arterial switch operation with extracorporeal membrane oxygenator support in patients older than three weeks of age. This report presents two cases in whom primary arterial switch operation with extracorporeal membrane oxygenator support was performed at the age of 110 days and 60 days, respectively. Primary arterial switch operation with extracorporeal membrane oxygenator support appears to be a more effective option in the short-term than alternative surgical management modalities.

Keywords : Extracorporeal membrane oxygenator; late arterial switch; transposition