Congenitally corrected transposition of the great arteries

Congenitally corrected transposition of the great arteries (cTGA) is an uncommon cardiac malformation characterized by discordant atrioventricular and ventriculoarterial connections. Most cases of cTGA are associated with cardiac anomalies. As the ventricular outflow tract may appear to arise correctly from the right and left ventricles, cases of cTGA with a mild associated anomaly are rarely detected prenatally. Parallel vessels are evident in cTGA, but this sign is also present in complete TGA. We report a case of cTGA diagnosed in utero at 29 weeks’ gestation. The fetus was diagnosed as TGA and referred to our hospital at 28 weeks’ gestation. cTGA was found at 29 weeks’ gestation in our hospital, and no additional cardiac anomalies were seen prenatally. After birth, patent ductus arteriosus with bidirectional flow was present. Careful examination of the four-chamber view suggested atrioventricular discordance. Identification of a parallel course of the great vessels, with the aorta anterior and to the left of the pulmonary trunk (l-transposition), may help accurate prenatal diagnosis of cTGA.     

完全性大动脉转位患儿大动脉调转术后的护理

完全性大动脉转位(transposition of the great arteries,TGA)是一种比较多见的发绀型先天性心脏病,其发病率占先天性心脏病的5%～8%,该病预后凶险,出生后第一年的生存率仅有10%[1].     

Mustard procedure for simple transposition of the great arteries

From May 1980 through April 1982, 9 patients underwent the Mustard operation for simple transposition of the great arteries (simple TGA) at the Tohoku University Hospital, Sendai. There was no early postoperative death, although one patient was lost with pulmonary venous obstruction in the late postoperative period. No pulmonary venous obstruction occurred since the introduction of expanded polytetrafluoroethylene (EPTFE) intraatrial baffle. Normal sinus rhythm has been preserved in all patients since direct, high superior vena cava cannulation was adopted. Postoperative hemodynamic study at an average 12 months after surgery revealed normal right ventricular function at rest. Work-function curve which is related to the right ventricular end-diastolic pressure and minute work index revealed good response of the right ventricle in two of three patients after methoxamine infusion test. All late survivors are acyanotic and clinically well. The Mustard procedure has dramatically improved the survival rate and quality of life for those with simple TGA. Presently, we continue to utilize the Mustard procedure for simple TGA until the superiority of other operations are demonstrated.     

The arterial switch procedure for transposition of the great arteries

TRANSPOSITION OF THE GREAT ARTERIES is the most common congenital heart defect among the birth defects that present with cyanosis during the early neonatal period.INFANTS WITH THIS CARDIAC BIRTH DEFECT, in which the aorta originates from the right ventricle and the pulmonary artery originates from the left ventricle, usually do not survive without surgical intervention in the first few days of life.THE ARTERIAL SWITCH PROCEDURE, performed via a median sternotomy incision during cardiopulmonary bypass, restores the aorta and pulmonary artery to their normal anatomic positions. AORN J 86 (August 2007) 211-226. © AORN, Inc, 2007.     

Transplantation after Mustard operation for transposition of the great arteries

As long‐term outcomes of congenital heart diseases improve, the probability of adult patients presenting for heart transplantation for late failure of congenitally corrected heart disease also increases. In patients with dextro‐transposition of the great arteries (d‐TGA) who were initially treated in the era of Mustard or Senning procedures and before Jatene procedure was introduced, progressive systemic right ventricular failure represents a problem in the very long‐term follow‐up. We report a rare case of heart transplantation as a third operation 36 years after Mustard procedure in a patient with d‐TGA experiencing late failure of the systemic right ventricle.     

Transthoracic echocardiography study of congenitally corrected transposition of the great arteries

Congenitally corrected transposition of the great arteries (CCTGA) is a rare congenital heart defect, occurring in only 0.5% of patients exhibiting congenital heart defects. Because it is not seen in a routine transthoracic echocardiography (TTE) examination, CCTGA may be missed. The echocardiography diagnosis of CCTGA is difficult and not well explained in most textbooks. The present report provides key sonographic images that contribute to the diagnosis. In the present case, the patient had no prior history of heart disease. TTE revealed that the patient had CCTGA and early tricuspid regurgitation with right ventricle enlargement and hypertrophy. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45 :375–379, 2017;