Health condition
Transposition repaired adults
Adults born with transposition of the great arteries carry one of two very different repairs: older atrial switch (Mustard or Senning) operations leave the right ventricle doing the main pumping work, while the modern arterial switch restores near-normal anatomy - and each needs distinct lifelong follow-up.
Why trust this guide
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Editorial team
Written by our editorial team from the UK sources listed on each page.
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Sourced from guidance
Checked against current NHS and UK specialist society guidance at the time of review.
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Current for 2026
Reviewed on 2026-09-27 with the next review scheduled for 2027-09-27.
Key points
What matters most, at a glance.
The essentials in plain English - symptoms, when to seek help, who to see and what treatment looks like.
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Knowing which operation you had - atrial switch or arterial switch - defines your follow-up needs; your ACHD team can confirm it
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After Mustard or Senning repairs, the systemic right ventricle can tire with age, and baffle narrowing or leaks and atrial arrhythmias are common
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After the arterial switch, follow-up focuses on the re-implanted coronary arteries and the pulmonary artery pathway
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New breathlessness, palpitations or fainting in either group warrants prompt ACHD review
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Pregnancy needs pre-pregnancy specialist assessment, particularly with a systemic right ventricle
Understanding it
About Transposition repaired adults, and what to do next.
In transposition the two great arteries arise from the wrong ventricles. Babies operated on before the late 1980s mostly had atrial switch procedures, re-plumbing blood at the top of the heart but leaving the right ventricle to sustain the body’s circulation for a lifetime - a task it was not designed for. The arterial switch, standard since, swaps the arteries themselves.
Atrial-switch adults benefit from surveillance of ventricular function, baffles and rhythm, often with MRI and periodic exercise testing; arterial-switch adults need less intensive but still lifelong review. Both groups do best enrolled with an ACHD centre rather than in general cardiology follow-up. Most people start with their GP, who can refer to a consultant cardiologist at an adult congenital heart disease (ACHD) specialist centre. In many parts of the UK, routine NHS referrals for this kind of problem currently take 20-45+ weeks, whereas an initial private consultation is typically available within around two weeks.
A quiet reminder
This guide is for information, not medical advice.
Your GP knows your history and can tell you which parts apply to you. If in doubt, see them - and seek urgent care for any emergency symptoms described above.
Frequently asked
Common questions about Transposition repaired adults.
Quick, plain-English answers to what people ask us most.
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What is repaired transposition of the great arteries in adults?
It describes adults who were born with transposition of the great arteries, a congenital heart defect where the main blood vessels are swapped, and who have since had corrective surgery, most commonly the arterial switch operation.
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What causes transposition of the great arteries?
It occurs due to abnormal development of the heart's outflow tracts in early pregnancy; the exact cause is usually unknown, though it can occasionally be linked to genetic or maternal factors.
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What symptoms might adults with repaired transposition experience?
Many live full, active lives, but some develop breathlessness, palpitations, reduced exercise tolerance, or symptoms of valve or coronary artery problems as they get older, related to the original surgery type.
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Is repaired transposition dangerous long-term?
Lifelong follow-up is important because certain repairs carry risks such as narrowing at the surgical sites, valve dysfunction, coronary artery issues, or arrhythmias, some of which can be serious if unmonitored.
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Is transposition of the great arteries hereditary?
It is usually not strongly hereditary, though having a close relative with a congenital heart defect very slightly raises the risk, and genetic counselling may be offered in some cases.
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Can repaired transposition be considered cured?
The original defect is corrected, but it is best thought of as a lifelong condition needing ongoing specialist cardiology follow-up rather than something fully cured, because of the risk of late complications.
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How is it monitored and treated?
Regular review with a congenital (adult) cardiologist, including echocardiograms and sometimes MRI, monitors heart and valve function; some adults need further procedures for arrhythmias, valve problems or narrowed vessels.
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How does life expectancy and activity look after repair?
Most people who have had a successful arterial switch operation lead near-normal lives with appropriate follow-up, though exercise advice and monitoring are individualised based on the specific repair and any residual issues.
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Arterial switch vs atrial switch repair - what's the difference?
The arterial switch, now the standard approach, corrects the anatomy directly and generally has better long-term outcomes, while the older atrial switch (Mustard or Senning) redirects blood flow at the atrial level and carries a higher long-term risk of arrhythmia and right heart strain.
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When should adults with repaired transposition seek specialist review, and how quickly can it be arranged privately?
Any new breathlessness, palpitations or reduced exercise tolerance should prompt review by an adult congenital heart disease specialist. NHS specialist referral can take some weeks; private cardiology assessment can often be arranged within about two weeks.