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Results for “TRANSPOSITION OF GREAT VESSELS”

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PubMed1990

[Long-term follow up of children with transposition of great vessels with intact interventricular septum].

From January 1971 to January 1988, 140 patients were diagnosed of complete transposition of the great arteries with an intact ventricular septum. These patients are the 6% of the 2,322 children diagnosed of congenital heart disease by catheterization and angiography in this 17 year period. The overall mortality was 63.5%. Sixty children died at a mean age of 55 days before cardiac surgery was performed, mostly before 1982. Forty nine patients underwent a Senning procedure with a surgical mortality of 30.6%. Between 1983 and 1988, with the use of infusion of prostaglandin E in the neonatal period, 28 children underwent a Senning procedure at a mean age of 12 months with a surgical mortality of 17.8%, and an actuarial survival rate of 80.9%. At late examination the 55.8% of the survivors were asymptomatic and the 8.8% showed caval or pulmonary venous obstruction.

Child↗
PubMed1997

[Complete transposition of great vessels: clinical aspects, diagnosis, echocardiography].

The paper reports the study of 12 patients admitted to hospital between January 1992 and October 1994. The patients were almost all neonates. Clinical, electrocardiographic and radiological data led to the suspected diagnosis of complete transposition of the great vessels. 2-D echocardiography consistently showed the parallel disposition of great vessels, the anterior position of the aorta compared to the pulmonary artery, the origin of the pulmonary artery from the left ventricle and the aorta from the right ventricle, all of which are the anatomopathological characteristics of this congenital cardiopathy, together with associated malformations, thus enabling a certain diagnosis to be made. The authors underline the value of echocardiography in the diagnosis of complete transposition of the great vessels.

Age Factors↗
PubMed1993

[Comparison of long-term results of arterial switch and Senning procedure in transposition of great vessels with intact ventricular septum].

One hundred and five survivors after the 30th day of complete cure of transposition of the great arteries with intact ventricular septum between 1980 and 1985 were followed up. Fifty-four had an arterial switch (AS) in a single stage at an average age of 10 +/- 9 days and 51 had Senning's procedure (S) at an average age of 4 +/- 2.5 months. The average follow-up (97% of patients) was 5.8 +/- 1.1 years for the AS group and 9.3 +/- 2.3 years for the S group. The actuarial survival at 5 years was 100% in the AS group and 85.8% in the S group (p < 0.01) (8 late deaths). In the AS group, 3 patients were reoperated for stenosis of the pulmonary artery and, in the S group, 4 patients underwent 6 reoperations. All but 3 patients in the S group and all but 1 patient in the AS group are in functional Class I of the NYHA classification. Doppler echocardiographic studies have shown mild to severe dysfunction of the systemic ventricle in 2% of the AS group and 26% of the S group (p < 0.001). Holter monitoring, performed in 70% of patients in the S group showed sinus node dysfunction in 60% and sinus rhythm in 40% of cases. In conclusion, good functional results were observed at over 5 years in both groups. However, the absence of late mortality and the minimal incidence of systemic ventricular dysfunction in the AS group confirm the authors' choice of indication of arterial switch for the treatment of transposition of the great arteries with intact ventricular septum.

Actuarial Analysis↗
PubMed1979

Prenatal closure of the foramen ovale in complete transposition of great vessels. Observations in a case with intact ventricular septum and normally developed left heart chambers.

A rare case is reported of premature closure of the foramen ovale in d-transposition of the great vessels with intact ventricular septum and normal development of the left side of the heart. Asphyxia neoatorum and cardiac failure were the manifestations in the early neonatal period. Balloon atrial septostomy during cardiac catheterization would be unsuccessful in infants with this condition, and closed atrial septectomy (Blalock-Hanlon procedure) would be necessary for survival.

Asphyxia Neonatorum↗
PubMed1981

Echocardiographic features before and after the Jatene procedure (anatomical correction) for transposition of the great vessels.

Eight patients with complete transposition of the great vessels (TGA) underwent the Jatene procedure and repair of major associated anomalies. All were studied preoperatively by M-mode and two-dimensional echocardiography (2DE) and by cardiac catheterization. Six patients survived operation and were studied postoperatively by both echocardiographic methods; five also underwent cardiac catheterization and angiography. In these patients, 2DE accurately predicted the anatomic features preoperatively and provided an important adjunct to catheterization and angiocardiography.

Adolescent↗
PubMed1991

[Neonatal anatomical repair of transposition of great vessels associated with atrial septal defect. Apropos of 42 cases].

The good results obtained by anatomic correction of simple transposition of the great arteries (TGA) in the neonatal period have incited some surgical teams to widen the indications to neonates with TGA associated with ventricular septal defect (VSD). The classical management of these patients is a two stage procedure: banding of the pulmonary artery followed by detransposition, which carries a certain risk. Between January 1985 and June 1990, 42 neonates with TGA and VSD underwent a combined procedure consisting in anatomic correction of the TGA and closure of the VSD. The average age of these patients was 16 days, and the average weight was 3.3 kg. Ten patients had coarctation and 6 underwent a complete one stage correction by an anterior approach. The surgical technique consisted in closing the VSD from the right atrium in 20 patients, from the right ventricle in 11 patients and from the pulmonary artery in 11 patients, associated with detransposition of the great arteries and coronary artery reimplantation. Three children died in the preoperative period (7.1%). In two cases, death was related to malposition of the coronary artery. The third fatality was the result of haemorrhage. There has been one late death three years after surgery. Four patients have been reoperated for stenosis of the right ventricular outflow tract (1 case), recurrence of coarctation (2 cases) and stenosis of the superior vena cava (1 case) and have survived. All patients were followed up for an average period of 26.4 +/- 19 months. They are all in the NYHA Class I without treatment. One patient has mild aortic regurgitation.(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗
PubMed1978

[Long-term results of 156 Mustard operations for simple transposition of the great vessels].

156 children with simple transposition of the great vessels have been operated on by Mustard's technique between 1-6-1967 and 31-12-1976, with an immediate overall mortality rate of 8%. In the longterm, the 9% of late deaths and more especially the complications are regrettable; complications were either of severe arrhythmia (almost 30%) leading to 2 late deaths and 7 pacemaker implantations, or venous obstruction relating to problems with the patch (25%). Despite the improved techniques and consequent reduction in surgical mortality and late complications, longterm prognosis is still unsure because of the unknown fate of the intra-atrial partition, and that of the "passive" rhythms which are so commonly found after this type of surgery.

Adolescent↗
PubMed1970

Ventricular inversion without transposition of the great vessels in situs inversus.

A classification of one type of congenital malformation previously reported (de la Cruz et al., 1967) is based on the integration of an embryological theory for ventricular inversions with the embryological concepts of trunco-conal malformations (de la Cruz and da Rocha, 1956). In that classification we consider that in each situs, either solitus or inversus ventricular inversions may be associated with: (a) normally arranged great vessels (not transposed); (b) transposition of the great vessels; (c) persistent truncus arteriosus. The patients had ventricular inversion without transposition of the great vessels in situs inversus.THE CORRECT ANATOMICAL DIAGNOSIS WAS NOT FORESEEN BUT THE PHYSIOPATHOLOGICAL DIAGNOSIS WAS CORRECT: pulmonary ischaemia associated with septal defects. In one case these facts were substantiated by catheterization and by angiocardiographic findings which led us to advise surgery. Haemodynamically isolated inversion of the ventricles is as severe a malformation as complete (not corrected) transposition of the great vessels. However, an operation of the anastomotic type between a systemic vessel and the narrow pulmonary artery seemed justified in these cases, as a means to convey more blood to the lungs and improve the saturation of the arterial blood. It was unsuccessfully carried out in one patient.The anatomical, radiological, and electrocardiographic features which might aid in the diagnosis are analysed.

Adult↗