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PubMed1990

[Transposition of the great vessels in western Africa. Apropos of 17 cases observed at the Institute of Cardiology in Abidjan].

During the last 10 years, 17 children with transposition of the great arteries (TGA) were admitted to the Cardiology Institute of Abidjan: 1 case between March 1978 and December 1985, 16 cases between January 1986 and December 1989. The average age was 58 days (range 5 to 270 days) at the first consultation, and 90 days (5 to 270 days) at the time of admission. The diagnosis was confirmed by echocardiography and hemodynamic investigation in 12 cases. There were 9 simple forms of TGA, 7 with ventricular septal defects (VSD) and 1 with VSD and pulmonary stenosis. Two children were taken back by their parents before any treatment was given. A Rashkind atrial septostomy was carried out in 11 children which increased aortic oxygen saturation from 35 +/- 18 percent to 57 +/- 19 percent; there were 3 unsuccessful procedures in children aged 2, 3 and 5 months with 2 deaths. Five patients later underwent surgical correction by a Senning procedure in 4 cases and anatomical correction in 1 case with VSD. All are well after an average 15 months follow-up (1 to 48 months). One of the 8 children awaiting surgery died. Therefore, TGA is not a rare abnormality in Black Africa; it represents 2 percent of the 887 cases of congenital heart disease observed during the same period. The inadequacy of means of diagnosis is certainly the cause of the relatively low incidence of this malformation, of the considerable delay in under specialist care and, as a consequence, of the greater difficulties in treatment, especially with regards to atrial septostomy.(ABSTRACT TRUNCATED AT 250 WORDS)

Angiocardiography↗
PubMed1975

Palliative treatment of complete transposition of the great vessels: First clinical results of closed atrial septectomy with new septectome.

Our initial method of closed atrial septectomy, used in the palliative therapy of transposition of the great arteries (TGA), failed to produce a technical success in 1 of 5 patients. Subsequently, we modified the technique by securing the septum on traction sutures and simplifying the introduction of the septectome. With the new method, we achieved technical success in all 13 patients so treated. In our total of 18 patients treated by closed atrial septectomy, 7 had TGA with no other cardiac anomaly, and none of the 7 died. Of the remaining 11 patients who had TGA and other cardiac anomalies and required procedures such as ductus ligation, pulmonary artery banding, and aorta-right pulmonary artery shunt in addition to septectomy, 5 died. In only 1 of them, death was caused by technical complications with our initial method. Of the remaining four deaths, two were due to pre-existing cerebral damage and two to complications of palliative procedures done in conjunction with atrial septectomy. Side-to-side anastomosis between the superior vena cava and right pulmonary artery, carried out successfully in 1 case, is suggested as an additional palliative measure to supplement atrial septectomy in TGA.

Cardiac Surgical Procedures↗
PubMed1983

[Corrected transposition of the great vessels associated with severe pulmonary stenosis in a 59-year-old man].

The case of a 59-year-old man with corrected transposition of the great arteries (CTGA) is reported. This anomaly is rare in adult patients, uncommon in patients over 50. Most of the cases with CTGA are diagnosed in childhood because of associated cardiac abnormalities. When isolated or complicated by other mild anomalies, CTGA can cause no symptoms until adult life or can even go unrecognized. However, most of these patients present with congestive heart failure when they are 40 or 50 years old. Our patient was admitted to the hospital because of heart failure. Cardiac catheterization and selective angiography demonstrated a CTGA associated with severe pulmonary valve stenosis. The case here reported shows that CTGA even when associated with other cardiac abnormalities, can be a relatively benign lesion, and can be revealed in adult life by signs of cardiac failure.

Humans↗