ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease: Executive Summary

Late diagnosis of a congenitally corrected transposition of the great arteries discovered at pacemaker implantation in a patient previously diagnosed with dextrocardia and situs solitus

“…This observation supports the idea that all patients with CCTGA and a complete heart block should be implanted from the outset with a biventricular pacemaker and epicardial leads, at least for those who require concomitant surgical procedures to correct associated defects 10. As said before, ventricular arrhythmias are rare in these patients, defibrillator implantation is recommended only after a cardiac arrest or after an episode of hemodynamically significant or sustained ventricular tachycardia (class IIA, level of evidence C) 1.…”

“…Congenitally corrected transposition of the great arteries (CCTGA) is a rare cardiac condition representing less than 1% of cases of congenital heart diseases and is often associated with other cardiac malformations, such as perimembranous ventricular septal defects (70%), pulmonary or subpulmonary stenosis (40%), and abnormalities of the systemic atrioventricular (AV) valve (90% of patients have “Ebstein”‐like malformations) 1.…”

Improvement after Surgical Closure of Secundum Atrial Septal Defects in Adults

“…In pediatric patients, however, primary attention is directed to symptomatology of recurrent respiratory tract infections and failure to thrive. In adults, respiratory symptoms such as shortness of breath tend to occur [19,20].…”

Coronary Artery Fistulae

“…5 This reflects their propensity to become symptomatic. For small to medium fistulae, the recommendation is to intervene if they are symptomatic.…”