**1. Introduction**

186 Front Lines of Thoracic Surgery

Serraf, A., Roux, D., Lacour-Gayet, F. & et al. (1995). Reoperation after the arterial switch

Shaher, RM. (1964). Complete and inverted transposition of the great vessels. *Br Heart J*

Takeuchi, S. & Katogi, T. (1990). New technique for the arterial switch operation in difficult

Tang, T., Chiu, IS., Chen, HC. & et al. (2001). Comparison of pulmonary arterial flow

Toker, A., Tireli, E., Bostanci, K. & et al. (2000). Uncommon complication of arterial switch

Van Mierop, LH. (1971) Transposition of the great arteries. I. Clarification or further

Van Praagh, R. (2010). Normally and abnormally related great arteries: What have we

Williams, WG., Quaegebeur, JM., Kirklin, JW. & et al. (1997). Outflow obstruction after the

Yacoub, MH. & Radley-Smith R. (1978). Anatomy of the coronary arteries in transposition of

Yeh, T Kr., Ramaciotti, C., Leonard, SR. & et al. (2007). The aortic translocation (Nikaidoh)

situations. *Ann Thorac Surg* 50:1000-1, ISSN 0003-4975

*Thorac Cardiovasc Surg* 122:529-34, ISSN 0022-5223

confusion? *Am J Cardiol* 28:735-8, ISSN 0002-9149

ISSN 0022-5223

ISSN 2150-1351

114:975-90, ISSN 0022-5223

33:418-24, ISSN 0040-6376

*Surg* 133:461-9, ISSN 0022-5223

26:51-66, ISSN 0007-0769

operation for transposition of the great arteries. *J Thorac Cardiovasc Surg* 110:892-9,

phenomena in spiral and Lecompte models by computational fluid dynamics. *J* 

operation: tracheobronchial compression. *Ann Thorac Surg* 69:927-9, ISSN 0003-4975

learned? *World Journal for Pediatric and Congenital Heart Surgery* October: 364-385,

arterial switch operation: a multiinstitutional study, *J Thorac Cardiovasc Surg*

the great arteries and methods for their transfer in anatomical correction. *Thorax*

procedure: midterm results superior to the Rastelli procedure. *J Thoracic Cardiovasc* 

Congenital heart defects (CHD) affect approximately 1% of live births. Some of them are associated with a significant morbidity and mortality and congenital heart diseases remain the first cause of death among infants in North America and Europe (Bruneau, 2008).

The major causes in CHD are thought to be chromosomal aberrations or mutations in genes regulating cardiac development during embryogenesis (Pierpont et al., 2007). However, from the epidemiological data, it seems that the environment can have a small "teratogenic" effect (Jenkins et al., 2007). For example, some substances (e.g. prenatal exposure to angiotensin converting-enzyme inhibitors, alcohol abuse and Rubella virus) can alter the function of certain genes during embryogenesis (Bruneau, 2008; Cooper et al., 2006). Though, these epidemiological studies have mostly suggested risk rather than pinpointing the underlying disease mechanisms.

During heart development complex interactions, among cells originating from different cell lineages, occur. In normal human heart development, a four-chambered heart ensure normal cardiac physiology with a right heart serving to the low-pressure pulmonary system and a left heart to the high pressure body circulation (Srivastava, 2004). A malformed cardiac growth results in abnormal hemodynamic characteristics because of volume or pressure overload leading to an adaptation process of the heart.

The completion of the Human Genome Project heralded the beginning of a new medical science era. The available genomic data will markedly improve our ability to diagnose and treat a great number of diseases including heart disease. Examining an individual's genomic profile or "molecular fingerprint" in a disease context now might help us to understand disease mechanisms and could found a new health care tailored to individual patient that take into account the predicted disease course and response to therapies of that patient. There's now a real opportunity to replace invasive diagnostic tests with genomic tests that can be carried out with no or little risk or stress to the patients (Bell, 2004; Collins et al., 2003).

The objective of this chapter is to provide an overview of gene expression profiling technology and the state of genomic research in congenital heart diseases, specifically with regard to the use of microarray approach.
