Portadora de transposição das grandes artérias operada em idade pré-escolar

Abstract

Portadora de transposição das grandes artérias operada em idade pré-escolar A child with transposition of the great arteries submitted to surgical correction at preschool age CLINICAL DATA On the 4 th day of life, an Afro-Brazilian female child born in Paulínia, São Paulo, presented cyanosis of extremities. The patient was given prostaglandin. She was referred to our Pediatric Cardiovascular Surgery Service after congenital heart disease was diagnosed. At this moment, the radiography resembled to both an oval-shaped cardiac area and an electrocardiogram with left ventricle overload. The echocardiogram suggested a transposition of the great arteries [TGA], perimembranous interventricular communication (IVC), ostium secundum interatrial communication (IAC), severe preductal aortic coarctation, and patent ductus arteriosus with a greater diameter. As the team was in both structural and learning phases, it was chosen to perform a staged surgical repair (correction) with terminoterminal (end-to-end) aortoplasty, ligation, and resection of ductus arteriosus. Additionally, a balloon catheter atrioseptostomy (Rashkind) was performed during the hemodynamic study carried out two days prior to the surgery. Both parents were given instructions to keep the outpatient clinic follow-up. However, they were absent until the aggravation of the cyanosis when they have brought the child back to our service. The child was 4 years old, weighting 14.6 kg, in REG, hydrated, eupneic, and with cyanosis ++++/4+. The lungs were free; heart rhythm was regular with two clicks, with a hypophonetic second heart sound; effective systolic murmur ++/4+ in medium-below left sternal border. There is no abdominal tenderness on