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PubMed1980

Surgical transposition of the atria: A new procedure for repairing transposition of the great vessels.

The proposed procedure consists of interchanging the positions of the atria by means of an incision used in heart transplantation. After frontal sectioning of the atrial body, the heart is turned up on its pedicle, the interatrial septum is divided in its posterior part, and the vena cavae are extensively freed from their mediastinal and diaphragmatic attachments. The posterior parts of the atria can then be transposed: the right atrium and vena cava are repositioned to the left of the left atrium, and a new septum is constructed by joining the external atrial walls. The heart can then be replaced and the walls of the transposed atria repaired by edge-to-edge sutures. Cadaver experiments have indicated that this procedure is applicable in infants and young people. Casts and radiologic examinations have shown no strictures in the vena cavae, and the possibility of postoperative arrhythmias has been evaluated by means of electrocardiographic studies in dogs surviving for long periods after heart autotransplantation.

Journal Article↗
PubMedDate not supplied

Method for cardiac transplantation in corrected transposition of the great arteries.

A patient with corrected transposition of the great vessels (L-transposition) required cardiac transplantation because of severe myopathy of th systemic ventricle of right ventricular morphology. Because of the L-transposition of the great vessels, a modification of the transplantation procedure was necessary in order to make the great vessel anastomoses. This was accomplished without the need for prosthetic material primarily by extensive removal of donor pulmonary artery and aorta together with the heart. Anastomosis of the recipient ascending aorta was accomplished to the superior aspect of the transverse aortic arch of the donor, and the recipient pulmonary artery to the superior portion of the right pulmonary artery of the donor. The postoperative hemodynamics were normal and a thoracic aortogram one year post-transplant demonstrated the unusual anatomy.

Adult↗
PubMed1975

[Isolated corrected transpostion of great vessels].

Isolated corrected transposition of the major vessels is a rare congenital pathology that may have an asymptomatic course. In some cases the patients develop some symptoms of cardiac pathology due to the disorders in the atrioventricular conductivity and the development of "mitral" insufficiency. The disturbances in the atrioventricular conductivity and in the cardiac rhythm may be provoked in such patients by intercurrent diseases due to intoxication, and the development of "mitral" insufficiency is brought about by the peculiarities of the structure of the arterial morphologically right ventricle working under functional tension. The diagnosis of an isolated corrected transposition of the major vessels is based on the data of electrocardiography and X-ray. The final diagnosis is made after heart catheterization and angiocardiography.

Adolescent↗
PubMed2000

[Postoperative left ventricular function in patients with transposition of the great blood vessels].

UNLABELLED: During August 1996 to August 1998 at the Paediatric Clinic in Sarajevo, 8 patients (pts) have been diagnosed to have a Transposition of the Great Arteries (TGA), age 10 hrs to 31 days. First Group (n = 4) had a simple TGA and in II Group in 3 pts TGA was associated with double inlet left ventricle (DILV) and subpulmonary artery stenosis and in 1 with double outlet right ventricle (DORV) and subpulmonary artery stenosis. Anatomical correction of TGA-arterial switch has been performed in Group I, mean age 15.5 days (7-18). In Group II palliative correction has been completed in: atrioseptectomy (1/4), pulmonary artery banding (3/4), right Blalock-Tausing modified shunt and also partial correction: Glenn anastomosis, mean age 4.7 months. Pts have been followed from 3 to 19 months postoperatively. All pts are well, except 1 pt who died following the arterial switch (mortality rate 12.5%). The aim of this study is to evaluate left ventricle (LV) function pre and postoperatively with electrocardiographic monitoring. Electrocardiographically there was no significant rhythm disorders. Using M mode echocardiography techniques, LV function was measured including internal dimensions of the LV as well as a wall thickness and than compared with the others comparable to the age and body weight. LV function in pts post anatomical correction has returned to normal values faster, with statistically significant difference of p = 0.02, than in pts post palliative-partial correction. CONCLUSION: Echocardiographically LV function in pts with TGA post arterial switch returned faster to normal values than in pts following the palliative-partial correction.

Cardiac Surgical Procedures↗