An arterial switch operation is a surgery used to treat a congenital heart defect called transposition of the great arteries (TGA). TGA is a birth defect in which the heart is basically wired backwards, with the two main arteries (the aorta and the pulmonary artery) connected to the wrong sides of the heart. As a result of this misplacement, oxygen-rich blood from the lungs is sent back to the lungs, and oxygen-poor blood from the body is sent back to the body. Immediate survival depends on the blood in these two parallel circulations mixing, either because of additional defects that allow blood to mingle, or because of medical intervention. However, even after the two circulations are able to mix, the circulation of oxygen-rich blood remains inefficient. As a result, the tissues of the body do not receive enough oxygen. The most common symptom is a bluish tinge in the skin, lips, fingernails and other parts of the body (blue baby).

During an arterial switch operation, the two misconnected arteries are moved to the correct locations. The arterial switch operation is an open-heart surgery that carries a slightly greater risk of complications than the surgery formerly done most commonly to treat TGA: the intraatrial baffle. To reduce the risk of complications, people are urged to find a pediatric heart surgeon with extensive experience in performing this surgery.

The arterial switch operation also offers greater potential life expectancy than any other treatment for TGA that has been developed to date. If patients follow up with their cardiologist regularly, and take antibiotics before any dental, medical or surgical procedures, then they can generally expect to live longer than if they had undergone the intraatrial baffle.