Transposition of the Great Arteries

2018 ◽  
Author(s):  
Andrew T. Waberski ◽  
Nina Deutsch
Keyword(s):  
Neonatal Period ◽  
Arterial Switch Operation ◽  
Anesthetic Management ◽  
Systemic Circulation ◽  
Definitive Treatment ◽  
Cardiac Abnormality ◽  
Hemodynamic Compromise ◽  
Switch Operation ◽  
Complications Of Surgery ◽  
The Right

Transposition of the great arteries is a congenital cardiac abnormality that presents in the neonatal period, most commonly as cyanosis. While variations in anatomic features exist, dextro-transposition of the great arteries, the most common form, results in 2 separate circulatory systems in parallel, such that the right ventricle pumps deoxygenated blood to the systemic circulation, and the left ventricle sends oxygenated blood back to the pulmonary circulation. To ensure survival, early diagnosis and intervention to allow for adequate mixing of blood is necessary. The arterial switch operation is the definitive treatment, usually undertaken in the first few days of life. Known complications of surgery include ischemia, bleeding, hemodynamic compromise, and arrhythmias. Anesthetic management must take these factors into account.

Transposition complexes

2017 ◽  
Author(s):  
Sara Thorne ◽  
Sarah Bowater
Keyword(s):  
Arterial Switch Operation ◽  
Systemic Circulation ◽  
Complete Transposition ◽  
Switch Operation ◽  
Senning Operation ◽  
The Right ◽  
The Relationship ◽  
Congenitally Corrected Transposition ◽  
Rastelli Operation ◽  
Corrected Transposition

Transposition complexes refer to hearts in which there is a reversal in the relationship between the ventricles and great arteries, i.e. there is ventriculoarterial discordance. Thus, the right ventricle gives rise to the aorta and supports the systemic circulation, whilst the left ventricle becomes the subpulmonary ventricle. There are two types of transposition: complete transposition of the great arteries (TGA) and congenitally corrected TGA. This chapter discusses complete TGA, including interarterial repair (Mustard or Senning operation), arterial switch operation, and Rastelli operation. It also covers congenitally corrected transposition of the great arteries (ccTGA), including atrioventricular (AV) and ventriculoarterial (VA) discordance.

Iatrogenic “aortopulmonary window”: percutaneous rescue closure as a bridge to surgical repair

2015 ◽  
Vol 26 (3) ◽  
pp. 609-611 ◽  
Author(s):  
Davide Marini ◽  
Gaetana Ferraro ◽  
Gabriella Agnoletti
Keyword(s):  
Surgical Repair ◽  
Arterial Switch Operation ◽  
Pulmonary Trunk ◽  
Aortopulmonary Window ◽  
Severe Stenosis ◽  
Severe Scoliosis ◽  
Switch Operation ◽  
Septal Occluder Device ◽  
Occluder Device ◽  
The Right

AbstractWe present the case of a 15-year-old boy who underwent arterial switch operation due to transposition of the great arteries with severe scoliosis, obstruction of the right coronary ostium, and severe stenosis of the pulmonary trunk. Balloon angioplasty caused a large aortopulmonary shunt provoking myocardial ischaemia and pulmonary hypertension. The traumatic “aortopulmonary window” was percutaneously occluded using an Amplatzer Septal Occluder device as a bridge to surgical repair.

Do infants with transposition of the great arteries born outside a specialist centre have different outcomes?

2019 ◽  
Vol 29 (8) ◽  
pp. 1030-1035 ◽  
Author(s):  
Colin Veal ◽  
Richard Hunt ◽  
Lyvonne N. Tume
Keyword(s):  
Arterial Switch Operation ◽  
Secondary Data ◽  
District General Hospital ◽  
Definitive Treatment ◽  
General Hospitals ◽  
Arterial Switch ◽  
Tertiary Centre ◽  
South Wales ◽  
Switch Operation ◽  
Specialist Centre

AbstractBackground:Infants born with undiagnosed transposition of the great arteries continue to be born in district general hospitals despite the improvements made in antenatal scanning. Evidence indicates improved outcomes with early definitive treatment after birth, hence the recommendation of delivery in a tertiary centre. The role of specialist paediatric and neonatal transport teams, to advise, stabilise, and transport the infants to a tertiary centre in a timely manner, is critical for those infants born in a district general hospital. This pilot study aims to compare outcomes between infants born in district general hospitals and those who were born in a tertiary maternity unit in South West England and South Wales.Methods:This was a secondary data analysis of data collected from the local Paediatric Intensive Care Audit Network and the local transport database. Infants born with a confirmed diagnosis of transposition of the great arteries, that required an arterial switch operation as the definitive procedure between April, 2012 and March 2018 were included.Results:Forty-five infants with a confirmed diagnosis of transposition of the great arteries were included. Statistical analysis demonstrated there were no significant differences in the time to balloon atrial septostomy (p = 0.095), time to arterial switch operation (p = 0.461), length of paediatric ICU stay (p = 0.353), and hospital stay (p = 0.095) or mortality between the two groups.Conclusions:We found no significant differences in outcomes between infants delivered outside the specialist centre, who were transferred in by a specialist team.

Paediatric coronary artery bypass grafting for coronary hypoperfusion late after arterial switch operation

2011 ◽  
Vol 21 (4) ◽  
pp. 460-461 ◽  
Author(s):  
Farhad Bakhtiary ◽  
Wilfried Bellinghausen ◽  
Martin Kostelka
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Arterial Switch Operation ◽  
Artery Bypass ◽  
Off Pump ◽  
Arterial Switch ◽  
Main Coronary Artery Stenosis ◽  
Switch Operation ◽  
Pump Coronary Artery Bypass ◽  
The Right

AbstractA case of left main coronary artery stenosis is presented in a boy late after an arterial switch operation, with significant ischaemia during exercise with good collateralisation through the right coronary artery. The problem was successfully managed with minimally invasive off-pump coronary artery bypass through median re-sternotomy.

scholarly journals EGFR Mutated Lung Adenocarcinoma with Secondary Glaucoma as Early Manifestation: A Case Report

2021 ◽  
Vol 7 (1) ◽  
pp. 14
Author(s):  
Ida Ayu Jasminarti Dwi Kusumawardani ◽  
Venny Singgih ◽  
Ni Wayan Candrawati ◽  
Putu Yuliawati ◽  
Herman Saputra ◽  
...  
Keyword(s):  
Growth Factor Receptor ◽  
Systemic Circulation ◽  
Direct Access ◽  
Definitive Treatment ◽  
Orbital Metastasis ◽  
Orbital Metastases ◽  
Epidermal Growth ◽  
The Right ◽  
Specific Symptoms ◽  
Egfr Mutated

Background: Orbital metastases are rare in pulmonary adenocarcinoma and can be manifested as glaucoma.Case: A 64-year-old male patient complained of swelling, redness, painful and protruded left eye. Physical and radiological examination revealed mass in the right lung, retrobulbar intraconal mass of the left oculi, and metastases in the ribs, liver, brain, and vertebrae. Result of bronchial mucosal biopsy showed adenocarcinoma. Epidermal growth factor receptor (EGFR) mutation examinations detected exon 19 deletions, therefore Gefitinib was given. Left orbital exenteration was performed and obtained a biopsy result of adenocarcinoma metastases.Conclusion: Orbital metastasis occurs by hematogenous pathway due to direct access of systemic circulation to left orbital blood flow. Glaucoma as a symptom of orbital metastases can appear before primary tumor symptoms, because lung cancer often does not show specific symptoms until advanced stage. Definitive treatment consists of targeted therapy and surgical management for metastases.

THE EFFECTS OF PROLONGED NEONATAL HYPOXEMIA ON THE PULMONARY VASCULAR BED AND HEART

PEDIATRICS ◽  
1962 ◽  
Vol 30 (6) ◽  
pp. 902-908
Author(s):  
Richard L. Naeye ◽  
Harry W. Letts
Keyword(s):  
Smooth Muscle ◽  
Pulmonary Arterial Hypertension ◽  
Right Ventricle ◽  
Arterial Hypertension ◽  
Neonatal Period ◽  
Pulmonary Arteries ◽  
Systemic Circulation ◽  
Vascular Bed ◽  
Pulmonary Arterial ◽  
The Right

Changes in the blood vessels and heart were assessed in infants chronically hypoxemic during the neonatal period. The hypoxemia appears to arrest the relative involution of smooth muscle about the pulmonary arterial bed. This change is presumably related to persistent pulmonary arterial hypertension, as evidenced by a relative hypertrophy of the right ventricle in the hypoxemic infants. The small pulmonary arteries are identified as a possible site of hypoxemia-induced vasoconstriction. No abnormalities were found in the veins or capillaries of the pulmonary circulation or in any vessels of the systemic circulation.

Anatomic correction of complete transposition with ventricular septal defect in neonates: experience with 42 consecutive cases

1991 ◽  
Vol 1 (1) ◽  
pp. 101-103 ◽  
Author(s):  
Claude Planché ◽  
Alain Serraf ◽  
François Lacour-Gayet ◽  
Jacqueline Bruniaux ◽  
François Bouchart
Keyword(s):  
Left Ventricle ◽  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Arterial Switch Operation ◽  
Systemic Circulation ◽  
Ventricular Septum ◽  
Intact Ventricular Septum ◽  
Complete Transposition ◽  
The Poor ◽  
Switch Operation

Perhaps paradoxically, it was in the form of complete transposition with a ventricular septal defect rather than an intact ventricular septum that the arterial switch operation was first successfully applied. This was, in part, because of the poor results of the physiologic repair in the presence of a ventricular septal defect, but more because the left ventricle, in the presence of the septal deficiency, is immediately suitable for supporting postoperatively the increased workload imposed on the systemic circulation. Spurred by this success, the procedure was then extended to neonates born with complete transposition and an intact ventricular septum and is currently employed with good results in this group.

scholarly journals A Cyanotic Newborn with a Pink Right Upper Extremity

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Matthias Beichl ◽  
Andreas Hanslik ◽  
Daniel Zimpfer ◽  
Judith Rittenschober-Boehm ◽  
Katrin Nagl ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Subclavian Artery ◽  
Heart Diseases ◽  
Arterial Switch Operation ◽  
Vascular Anomaly ◽  
The Body ◽  
Aortic Arch Anomaly ◽  
Switch Operation ◽  
Right Pulmonary Artery ◽  
The Right

Aberrant origin of the subclavian artery (SCA) is a well-known vascular anomaly as part of congenital heart diseases with the left subclavian artery (LSCA) being more frequently affected than the right subclavian artery (RSCA). Complete isolation of the SCA is an even more infrequent aortic arch anomaly, occurring in less than 1% for the LSCA and even less for the RSCA. Isolation of the RSCA in patients with d-transposition of the great arteries (D-TGA) is even scanter with only a hand full of cases being reported in the literature. However, isolation of the RSCA has important implications on hemodynamics and surgical strategies. In this case report, we present a newborn patient with D-TGA which presented with distinct differential cyanosis. While the right upper extremity appeared pink with an oxygen saturation of 100%, the rest of the body was cyanotic. At first, this appearance was interpreted as the Harlequin phenomenon during primary care. However, detailed echocardiography revealed an aberrant origin of the RSCA from the right pulmonary artery, which led to the differential cyanosis. The patient underwent arterial switch operation on day of life two including dissection and reimplantation of the RSCA. The special hemodynamic situation of this is discussed in terms of pathophysiology and as well as its impact on perioperative and surgical management.

scholarly journals Percutaneous coronary intervention in a 4-month-old infant for stenosis of both coronary arteries after arterial switch operation for transposition of the great arteries

2021 ◽  
pp. 1-3
Author(s):  
Hanna Kim ◽  
Jinyoung Song ◽  
I-Seok Kang
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Coronary Stenosis ◽  
Left Coronary Artery ◽  
Arterial Switch Operation ◽  
Coronary Intervention ◽  
Arterial Switch ◽  
Switch Operation ◽  
Percutaneous Coronary ◽  
The Right

Abstract We present a case of percutaneous coronary intervention in a 4-month-old infant with both severe coronary stenosis and acute heart failure after arterial switch operation for transposition of the great arteries. Under extracorporeal membrane oxygenation, balloon angioplasty of the left coronary artery with a 2.0 × 15-mm balloon and stent implantation on the right coronary artery with a 2.25 × 26-mm stent were performed successfully. Echocardiography after the intervention showed recovered cardiac function and no complications.

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