Between 1978 and June 1992, 213 patients were operated for transposition of the great arteries at our institution. 148 patients underwent atrial repair, 41 patients an anatomic repair and 24 patients only palliation. Since 1986 the anatomic repair has progressively replaced the arterial repair: 1978-1986 95-100% atrial repair, 1992 100% anatomic repair. At operation the average age of the patients treated by atrial repair was 22 months, resp. 10 months from 1986 to 1991, for anatomic repair 9 months, resp. 46 days in 1991/1992. The 30-day mortality for atrial repair was 11% (17/148), for anatomic repair 22% (9/41), resp. 12% (3/24) in 1991/1992. Potentially superior long-term results for anatomic repair are possible, but cannot be demonstrated at present.