Corrected Transposition of the Great Vessels

Beck, Walter; Schrire, V.; Vogelpoel, L.; Nellen, M; Swanepoel, A.

doi:10.1136/hrt.23.5.497

Cited by 15 publications

(11 citation statements)

References 12 publications

(2 reference statements)

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“…Table I Necropsy. The pathology of this condition has been described by Rokitansky (1875), Spitzer (1923), andHarris andFaber (1939). In three specimens in our series, the pulmonary trunk arose in the normal anterior position from the right ventricle.…”

Section: Anomalies Of the Great Arteriessupporting

confidence: 70%

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Anomalies of the Aorta and Pulmonary Arteries Complicating Ventricular Septal Defect

Morgan¹,

Pitman²,

Goodwin³

et al. 1962

Heart

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Section: Anomalies Of the Great Arteriessupporting

confidence: 70%

“…The clinical features have been quoted more recently by Anderson et al (1957), Kjellberg et al (1959), Schiebler et al (1961), and Beck et al (1961).…”

mentioning

confidence: 81%

Anomalies of the Aorta and Pulmonary Arteries Complicating Ventricular Septal Defect

Morgan¹,

Pitman²,

Goodwin³

et al. 1962

Heart

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“…In the presence of single ventricle it is not possible to differentiate between types 2 and 3. ANATOMY AND CASE REPORTS Type 1 Corrected Transposition (transposition with bulbo-ventricular inversion, Cardell's B3), 8 patients This type has been fully described (Walmsley, 1931;Harris and Farber, 1939;Liebow and McFarland, 1941;Anderson, Lillehei, and Lester, 1957;Schaefer and Rudolph, 1957;Fink et al, 1958;Kernen, 1958;Gasul, Graettinger, and Bucheleres, 1959;De La Cruz et al, 1959;De La Cruz, Polansky, and Novarro-L6pez, 1962;Malers et al, 1960;and Beck et al, 1961), but for purposes of comparison will be briefly reviewed here. Our patients 1-8 belong to this type but case histories will not be given in this type of corrected transposition.…”

Section: Subjectsmentioning

confidence: 99%

The Syndromes of Corrected Transposition of the Great Vessels

Shaher¹

1963

Heart

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In 1875 Rokitansky first described corrected transposition of the great vessels. Harris and Farber (1939) and Cardell (1956) thought that since inversion might occur in any part of the cardiac tube, in theory any one of eight types of transposition could result (Fig. 1). In their groups A3 and A4 the aorta arises from the morphological left ventricle but receives unoxygenated blood, hence they regarded it as being "corrected" anatomically but not physiologically. Their groups Bl and B2 associated with bulbus inversion, and sinu-atrial and ventricular inversion respectively, show both physiological and anatomical correction, the aorta arising from the morphological left ventricle and receiving oxygenated blood. In B3 and B4 associated with bulbo-ventricular inversion, and sinu-atrial inversion respectively, the aorta arises from the morphological right ventricle but receives oxygenated blood, hence it is corrected physiologically but not anatomically. Cardell (1956) and Harley (1958) suggested that the term corrected transposition should be confined to those cases with physiological correction only. Recent papers on the subject tend to confine the words "corrected transposition" to one anatomical type, i.e. the one associated with bulbo-ventricular inversion (Cardell's B3). Several papers have included cases of single ventricle among their material. The presence of a single ventricle vitiates any discussion of whether the transposition present is corrected or not, since mixing of the arterial and venous blood occurs in the common chamber. Several definitions have been given for corrected transposition, but we propose to use the term simply to define the condition where the transposed aorta receives oxygenated blood, and the transposed pulmonary artery receives venous blood. This paper is presented to describe three different types of corrected transposition that are readily recognizable whether there is lxvocardia or dextrocardia. Inversion means a reversal of the lateral relation between structures in the frontal plane. Complete transposition of the great vessels means that the aorta is lying anterior and to the right of the pulmonary artery, with livocardia. Inverted-transposition of the great vessels is used in the sense of Spitzer (1923) where the aorta is lying anterior and to the left of the pulmonary artery, with levocardia. During the course of the discussion cases of dextrocardia and levocardia will be mentioned. In order that these anomalies shall be properly understood, there should be a frame of reference which is that of normality, to which the abnormal situation may be compared in terms of inversion or transposition. The normal dextroposed heart in dextrocardia with situs inversus, with the venous chambers to the patient's left, is a mirror image of the normal lhvoposed heart in situs solitus. If in dextrocardia, the venous atrium is on the patient's right and the arterial on the left, they are by our definition inverted. This point is emphasized because this definition differs from that of Mande...

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“…In addition, pulmonary hernodynamic changes following administration of other nitrite or nitrate compounds have failed to yield conclusive results (2,(8)(9)(10)(11)(12). Hdmagyi et al (8) have attempted to clarify seemingly contradictory results by emphasizing the importance of preexisting pulmonary vascular tone in determining the vascular response to these compounds.…”

mentioning

confidence: 98%

“…Its ability to decrease systemic vascular resistance has been repeatedly demonstrated in both animals and man (1)(2)(3)(4). H o m e r , its specific action on the pulmonary circulation is not clearly defined.…”

mentioning

confidence: 99%

Effects of Amyl Nitrite on Pulmonary Vascular Resistance in the Dog

Kot

Humpert

1968

Experimental Biology and Medicine

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Amyl nitrite is a well-known and c m m l y employed musculatropic vasodilating agent. Its ability to decrease systemic vascular resistance has been repeatedly demonstrated in both animals and man (1-4). H o m e r , its specific action on the pulmonary circulation is not clearly defined.Both increases and decreases in pulmonary artery pressure have been recoded following amyl nitrite inhalation (2,s-7). The variability of responses observed may reflect secondary changes that are obscuring the pnimary action of this agent on the pulmonary vasculature. Alterations in cardiac output and bronchial blood flow, changes in pulmonary blood volume hand left atrial pressure, and psibly reflex responses could singly or in c mbination modify the expected response of the pulmonary vessels to the direct action of amyl nitrite.In addition, pulmonary hernodynamic changes following administration of other nitrite or nitrate compounds have failed to yield conclusive results (2,8-12). Hdmagyi et al. (8) have attempted to clarify seemingly contradictory results by emphasizing the importance of preexisting pulmonary vascular tone in determining the vascular response to these compounds.In the present investigation the effects of amyl nitrite on pulmonary vascular resistance were studied in the isollated left lower lobe of the dog's lung. With controlled perfusion of the isolated lobe administration of amyl nitrite consistently resulted in a decline in pulmonary vascular resistance.Methods. Ten mongrel dogs weighhg between 11.3 and 17.7 kg were amsthetized *Supported by a grant from the USPHS HE-08590. 1 This work was done during the tenure of an Established Investigatorship of the American Heart Asmianion. 2 Senior medical student, Georgetown University slahooll o f Medicine.with sodium pentobarbital (300 mg/kg) intravenously and placed on positive pressute respiration via endotrachd intubation.A left thoractmy was performed in t h e fifth intercostal space. Heparin (5 mg/kg) was administered intravenously. The drculation to the left lower labe of the lung was isolated from the remainder of the pulmonary circulation as follows. The lobar artery was dissected free of surrounding tissue and the proximal portion of the vessel was ligated. A polyethylene catheter, with a right-angle bend at the tip, was placed in the distal portion of the vessel and tied securely in place. In a simiilar manner venous effluent was collected by placing polyethylene catheters in the pulmomry vein or veins draining lthe isolated lobe. The bronchus was left intact to maintain adequate ventilation of the lobe.The isolated lobe was p e r f d with a u t e logous blood at controlled flow rates. The output of the Sigma-motor pump was adjusted to maintain ~a a n pulmonary artmy pressure between 10 and 20 mm Hg. All venous effluent was collected into an open-air reservoir a.nd r e t u r d to the pump, The outlet of the pulmonary venous catheter was positioned slightly below the level of the pulmonary veins (-2 t o -5 mm Hg) to insure adequate dmiraage. In this situati...

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Corrected Transposition of the Great Vessels

Cited by 15 publications

References 12 publications

Anomalies of the Aorta and Pulmonary Arteries Complicating Ventricular Septal Defect

Anomalies of the Aorta and Pulmonary Arteries Complicating Ventricular Septal Defect

The Syndromes of Corrected Transposition of the Great Vessels

Effects of Amyl Nitrite on Pulmonary Vascular Resistance in the Dog

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