Transposition of the Great Arteries with Multiple Interventricular Communications and Anomaly of the Coronary Arteries

Department of Cardiovascular CT and MRI of the Heart Hospital (HCor), São Paulo, Brazil |  22-01-2018

Valéria de Melo Moreira, MD, Adriano Camargo de Castro Carneiro, MD, Tiago Augusto Magalhães, PhD, MD, Juliana Hiromi Silva Matsumoto Bello, MD, Carlos Eduardo Elias dos Prazeres, MD, Caroline Bastida de Paula, BM and Carlos Eduardo Rochitte, PhD, MD

A neonate was born with a diagnosis of transposition of the great arteries (TGA) and isolated sub-pulmonary ventricular septal defect (VSD). A postnatal echocardiogram confirmed the diagnosis and additionally revealed an anomaly of the coronary arteries. In view of the cardiac anatomy, spatial arrangement of the great vessels associated with the coronary anomaly, a surgical palliation with pulmonary artery (PA) banding and atrioseptostomy was performed on day 14 after birth. Seven months later, the patient returned for scheduled Senning surgery. Clinical examination revealed an ejection systolic cardiac murmur in the left upper sternal border and cyanosis with blood oxygen saturation of 75% at room air. Senning surgery was performed with ventriculoseptoplasty and removal of PA banding. In the postoperative period, the patient developed complications, including significant worsening of the respiratory condition and difficulties in extubation. Postoperative echocardiography showed a suspicious cava baffle stenosis. Cardiovascular CT was requested to evaluate intra-atrial baffle abnormalities.

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1Jatene AD, Fontes VF, Paulista PP, Souza LC, Neger F, Galantier M, et al. Anatomic correction of transposition of the great vessels. J Thorac Cardiovasc Surg. 1976;72(3):364–70.

2Hutter PA, Kreb DL, Mantel SF, et al: Twenty-five years’ experience with the arterial switch operation. J Thorac Cardiovasc Surg 2002;124:790-797.

3Evans WN. The arterial switch operation before Jatene. Pediatr Cardiol. 2009;30:119-124.

4Fricke TA, d’Udekem Y, Richardson M, et al. Outcomes of the arterial switch operation for transposition of the great arteries: 25 years of experience. Ann Thorac Surg. 2012;94:139–45.

5Anderson BR, Ciarleglio AJ, Hayes DA, Quaegebeur JM, Vincent JA, Bacha EA. Earlier arterial switch operation improves outcomes and reduces costs for neonates with transposition of the great arteries. J Am Coll Cardiol. 2014;63(5):481–7.

6Lim HG, Kim WH, Lee JR, Kim YJ. Long-term results of the arterial switch operation for ventriculo- arterial discordance. Eur J Cardiothorac Surg. 2013;43:325–34

7Lalezari S, Bruggemans EF, Blom NA, Hazekamp MG. Thirty-year experience with the arterial switch

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