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Results for “TRANSPOSITION OF GREAT VESSELS”

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PubMed1994

Usefulness of magnetic resonance imaging for evaluating great-vessel anatomy after arterial switch operation for D-transposition of the great arteries.

Magnetic resonance imaging (MRI) produces high-resolution images of great-vessel anatomy in pediatric patients. In this study seven patients, aged 6 to 27 months were evaluated by using gated MRI and two-dimensional echocardiography 4 to 26 months after arterial switch operation for D-transposition of the great arteries. Measurements were taken at the right and left ventricular outflow tracts, beneath the semilunar valves, at the midaortic sinuses, at the anastomotic sites of the main pulmonary artery and the aorta, at the origin of the branch pulmonary arteries, and at the distal pulmonary arteries 1 cm beyond the bifurcation. Concordant results were obtained with both imaging techniques from all sides with the exception of the left pulmonary artery and the right pulmonary artery. With MRI, four patients had significant narrowing at the right pulmonary artery origin and six patients had narrowing at the left pulmonary artery origin. With two-dimensional echocardiogram, two patients had narrowing at the right pulmonary artery origin and four patients had narrowing at the left pulmonary artery origin. The measured pulmonary artery intraluminal diameters in these patients were consistently smaller when assessed by MRI versus two-dimensional echocardiography. To verify these results, five of seven patients underwent cardiac catheterization to provide physiologic correlation before reoperation; the MRI results were found to be significantly closer to the actual catheterization measurements. We conclude that MRI is a sensitive imaging technique for evaluation of great-vessel anatomy in patients after arterial switch operation for D-transposition of the great arteries. It is particularly useful in the evaluation of the branch pulmonary artery anatomy.

Aorta↗

PubMed1978

Great-vessel switch operation without coronary relocation for transposition of great arteries.

Since its first successful clinical application in 1963, the Mustard operation has been the procedure of choice for most patients with transposition of the great arteries. Based on the principle of transposition of venous return, it produces a functional but not anatomic correction of the defect. Although the Mustard procedure has favorably changed the natural history of transposition, it is associated with various early and late complications that have led to a search for a more anatomic repair. Recently, transposition has been successfully corrected by switching the great vessels, with or without transplanting the coronary arteries. These are the first case reports of early postoperative hemodynamics in patients undergoing an arterial switch procedure without coronary relocation. The early hemodynamic and clinical results of this operation are excellent and they lend encouragement for its further application in suitable patients.

Angiocardiography↗

PubMed1979

[Critical study of the morphogenesis of trunco-conal malformations].

Anatomical and angiocardiographic studies have made possible discussion of hypotheses of the development and differentiation of the conus and of the trunco-conal orientation of the septum. Three autopsy specimens and two angiocardiogrammes of intertwined great vessels with transposition and partial distortion of the great vessels were studied. The specimen of intertwined great vessels comprised a muscular sub-aortic infundibulum posterior to and greater than the pulmonary infundibulum. In the case of transposition the opposite situation was encountered with a muscular pulmonary infundibulum posterior to and greater than the sub-aortic infundibulum; the plane of the aortic valves was higher than that of the pulmonary valves. The specimen of partial distortion of the great vessels comprised a muscular sub-aortic infundibulum posterior to and greater than the pulmonary infundibulum with the aortic valve set higher and in fibrous continuity with the mitral valve. It is concluded that the relations of the great vessels between each other and with the ventricles depend on the orientation of the trunco-conal septum and on the process of incorporation of the cone. The presence or absence of a posterior muscular infundibulum is not related to the growth or differential reabsorption of the cone but to a process of cellular differentiation. There was no relation between the level of the valves and their spatial orientation and the length of the infundibulum. The continuity or discontinuity between the aortic and atrio-ventricular valves is not determined by the level of the aortic valves.

Female↗

PubMed1950