The causes of death were assessed in 140 infants and children with transposition of the great arteries studied clinically and post mortem. Half of the children were under one month old. Death occurred during the first year of life in 118 cases. Balloon atrial septostomy and/or cardiac surgery were performed in 37 cases, and 7 patients died following operations for extracardiac malformations. Congestive heart failure was the most common single cause of death, occurring in 109 cases. All but 7 patients were cyanotic. Extracardiac malformations were encountered in 39 patients and were considered a main cause of death in 22 of these. Various infections, mostly pneumonia, occurred in half of the cases. Forty-one patients had vascular accidents in various organs. These complications were more common in operated than in nonoperated cases. Miscellaneous causes of death, including hyaline membrane disease and/or pulmonary atelectases, occurred in 30 patients. The study illustrated the complex symptomatology and therapeutic problems presented by critically ill infants with transposition of the great arteries.
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