Transposition of the Great Arteries 25 years after Rashkind Balloon Septostomy

The international symposium on transposition of the great arteries was held in Munich on May 3-5, 1991. It was organized by the German Heart Center Muni eh with two aims: firstly, to commemorate the 25th anniversary of Dr. Rashkind's publication: "Creation of an atrial septal defect without thoracotomy" (which appeared in 1966 in the Journal of the American Medical Association), and to honor this great pediatric cardiologist, who was one the pioneers of interventional catheterization. secondly, to give an overview of current medical knowledge about the pre- and postnatal diagnosis, medical and surgical treatment, and postoperative evalua tion of transposition of the great arteries. Fig. 1. Dr. Rashkind in his Iabaratory checking his balloon catheter V This symposium brought tagether embryologists, morphologists, experts in fetal cardiology, pediatric cardiologists, and pediatric cardiac surgeons from 10 different countries. Thus, we were able to describe the current state-of-the-art of pre- and postnatal management and the surgical treatment of this second most common con genital cyanotic anomaly of the heart. Dr. Rashkind's approach to create an atrial septal defect in the setting of com plete transposition of the great arteries dramatically changed the natural history of this cyanotic heart defect, which carried a 90% neonatal mortality before this effec tive palliation became available.