Which corrective procedure is applied when there is both a VSD and pulmonary stenosis in transposition of the great arteries?

The presence of both a ventricular septal defect (VSD) and pulmonary stenosis in the context of transposition of the great arteries typically necessitates a combination of surgical interventions to effectively address the anatomical abnormalities and ensure proper circulation.

The Rastelli procedure is designed to create a connection between the left ventricle and the aorta after addressing the VSD, allowing for adequate blood flow from the heart to the systemic circulation. This procedure is particularly useful when there is a VSD present, as it not only facilitates the transition of blood but also manages the obstruction caused by pulmonary stenosis by providing an outflow tract to the right ventricle.

On the other hand, the Mustard-Senning procedure—traditionally used in cases of transposition of the great arteries without significant outflow tract obstruction—utilizes an atrial switch technique to reroute blood flow. In instances where there is an additional structural issue like pulmonary stenosis, the Mustard-Senning procedure may also be a part of the treatment strategy since it allows for the separation of oxygenated and deoxygenated blood.

Given these insights, both the Rastelli procedure for managing the VSD and pulmonary outflow tract obstruction, as well as the Mustard-Senning