Congenitally Corrected Transposition of the Great Arteries in a 65-Year-Old Woman.

Abstract

SUMMARYA 65-year-old Japanese woman was admitted to hospital because of exertional dyspnea. Transthoracic echocardiography showed diffuse hypokinesis of the left-sided ventricular wall, but was not clear enough to provide useful information because of the rotation of the cardiac apex and the presence of lung tissue. Systemic ventriculography showed that the left-sided ventricle with heavy trabeculations was morphologically similar to a normal right ventricle. Magnetic resonance imaging (MRI) clearly revealed corrected transposition of the great arteries. Because this patient had no severe associated cardiac anomalies, systemic ventricular dysfunction is thought to be the major cause of exertional dyspnea. MRI is a useful non-invasive method for the rapid evaluation of cardiac morphology. ( CONGENITALLY corrected transposition of the great arteries (CCTGA) is a rare cardiac anomaly 1) characterized by atrioventricular (AV) and ventriculoarterial discordance. However, few patients with this anomaly survive past 50 years of age because of associated congenital intracardiac anomalies such as pulmonary stenosis and ventricular septal defect, or systemic AV valve (anatomical tricuspid) regurgitation and subsequent development of systemic (morphological right) ventricular dysfunction or heart block. [2][3][4] In this paper, we describe a 65-year-old woman who had CCTGA with AV valve regurgitation. Magnetic resonance imaging (MRI) was useful for diagnosis.

Improvement in long-term survival after hospital discharge but not in freedom from reoperation after the change from atrial to arterial switch for transposition of the great arteries

“…Functional status appeared to be superior after the arterial switch relative to the atrial switch operations. According to different studies, 66% to 93% of the patients after atrial switch are in NYHA functional class I, 10,23,25 versus almost all patients after arterial switch, 26 a finding confirmed in our investigation (98% in NYHA functional class I after arterial switch). These subjective findings in functional status were reflected in the objective measurements of the cardiac function.…”

Congenitally corrected transposition of the great arteries: MDCT angiography findings and interpretation of complex coronary anatomy

“…Adult patients with CCTGA do not have a benign condition and rarely survive to old age [8]. The patients with this anomaly survive past 50 years of age because of associated congenital intracardiac anomalies such as pulmonary stenosis and ventricular septal defect, or systemic AV valve (anatomical tricuspid) abnormality [1]. Dextrocardia occurs in approximately 25% of patients [7].…”

“…ventriculoarterial (VA) discordance [1]. The clinical presentation generally depends on associated cardiac lesions, in particular ventricular septal defect and pulmonary stenosis.…”

Clinical situations where coronary CT angiography confers superior diagnostic information in comparison to coronary angiography

“…Congenitally corrected transposition of the great arteries (CCTGA) is a rare cardiac anomaly characterized by atrioventricular (AV) and ventriculoarterial (VA) discordance (7,8). In patients with CCTGA, the atrial situs relationship is normal; the right atrium (RA) is to the right of the left atrium (LA).…”