The “open sternum” acts like a medical and surgical “compromise” situation, used in pediatric cardiac surgery when the hemodynamic status, the hemostasis or respiratory parameters are unsatisfactory. At Târgu-Mureș Emergency Institute for Cardiovascular Diseases and Transplantation, between 2006-2016, 172 patients with transposition of great arteries underwent “arterial switch” operation at 6-24 days postpartum. The periprocedural factors, the number of “open sternum” days, infectious complications and location of the secondary sternum closure were studied. Secondary sternum closure was performed at a mean age of 15 days, a mean weight of 3.4 kg., mostly in the intensive care unit (93%) within 3-5 days postoperatively. The risk of infection was 12,7% compared to the clinics risk of 5,1%. The need for “open sternum” was proven to be a “lifesaving procedure” for patients with complex cardiovascular pathology. Risks related to local or systemic infection are minimized by the benefits of this procedure