oalib
Search Results: 1 - 10 of 100 matches for " "
All listed articles are free for downloading (OA Articles)
Page 1 /100
Display every page Item
Corrected transposition of the great arteries with several associated anomalies in a 68-year-old patient
Jacob, José Luiz Balthazar;
Arquivos Brasileiros de Cardiologia , 2001, DOI: 10.1590/S0066-782X2001001000005
Abstract: few patients with corrected transposition of the great arteries survive past 50 years of age because of the association with congenital defects, development of total atrioventricular block, and right ventricular dysfunction. we report the case of a male patient with dextrocardia in situs solitus and corrected transposition of the great arteries associated with a wide atrial septal defect and severe pulmonary valvar and subvalvar stenoses. the patient also developed a large aneurysm on the pulmonary artery, total atrioventricular block diagnosed 8 years earlier, symptoms of dysfunction of the systemic ventricle in the previous 2 years, insufficiency of the left atrioventricular valve, and aortic regurgitation. despite all these associated anomalies, the patient developed class iii cardiac decompensation only at the age of 68 years, which makes this case a rarity. the patient was clinically treated, and was discharged from the hospital in good condition.
Corrected transposition of the great arteries with several associated anomalies in a 68-year-old patient
Jacob José Luiz Balthazar
Arquivos Brasileiros de Cardiologia , 2001,
Abstract: Few patients with corrected transposition of the great arteries survive past 50 years of age because of the association with congenital defects, development of total atrioventricular block, and right ventricular dysfunction. We report the case of a male patient with dextrocardia in situs solitus and corrected transposition of the great arteries associated with a wide atrial septal defect and severe pulmonary valvar and subvalvar stenoses. The patient also developed a large aneurysm on the pulmonary artery, total atrioventricular block diagnosed 8 years earlier, symptoms of dysfunction of the systemic ventricle in the previous 2 years, insufficiency of the left atrioventricular valve, and aortic regurgitation. Despite all these associated anomalies, the patient developed class III cardiac decompensation only at the age of 68 years, which makes this case a rarity. The patient was clinically treated, and was discharged from the hospital in good condition.
A Case of Congenitally Corrected Transposition of the Great Arteries Discovered on Coronary Computed Tomography  [PDF]
Adam T. Marler,Jennifer N. Slim,Travis Batts,James Watts,Ahmad M. Slim
Case Reports in Vascular Medicine , 2013, DOI: 10.1155/2013/420213
Abstract: Congenitally corrected transposition of the great arteries is a rare condition accounting for less than 1% of all congenital cardiac diseases. The fundamental nature of this condition involves a blend of atrioventricular as well as ventriculoarterial discordance. Congenitally corrected transposition of the great arteries is classically associated with three additional abnormalities, including ventricular septal defect, right ventricular outflow tract obstruction, and tricuspid valve abnormalities. Patients with this anomaly have been shown to exhibit reduced exercise tolerance as well as reduced health-related quality of life when compared to patients with normal cardiovascular anatomy. We present the case of a 33-year-old active duty lieutenant in the United States Air Force referred to the cardiology clinic for evaluation of valvular heart disease with subsequent discovery of congenitally corrected transposition of the great arteries on cardiac gated computed tomography. 1. Case Report A 33-year-old male with a history of secundum atrial septal defect percutaneously ended in May 2008 referred for further evaluation of valvular heart disease. Transthoracic echocardiogram completed for a heart murmur was noted to be technically difficult with suboptimal image quality due to mesocardia. Official report from this examination detailed grossly normal left ventricular wall motion with moderate, posteriorly directed, eccentric mitral regurgitation, mild prolapse of the anterior mitral valve leaflet, mild aortic insufficiency, and an echo bright structure contiguous to the lateral aspect of the tricuspid annulus. The right ventricle and right atrium were not well visualized. At initial visit he reported feeling well overall, but he felt fatigued at 200–400 meters. Exercise stress testing was completed with the patient exercising 12 minutes 26 seconds on a standard Bruce protocol achieving a workload of 14.2 metabolic equivalents (METS) achieving 96% of maximal age-predicted heart rate with exercise. Exercise testing terminated due to fatigue with the patient reporting no chest pain during evaluation. No ischemic changes were noted on electrocardiogram during the study. Patient’s chest X-ray was suggestive of possible RV on the left side of the chest with possible dextrocardia or ccTGA in the differential (Figure 1). Figure 1: X-ray changes anticipated in ccTGA with right ventricular border outlined with red arrow and Amplatzer occluder device outlined with dark arrow. Subsequently, the patient underwent imaging evaluation with cardiac computed tomography (CT)
Transposición corregida de grandes vasos Corrected transposition of the great arteries
José Rafael Escalona Aguilera,Alberto Ramírez Ramos,Marcia López García
Revista Cubana de Pediatr?-a , 2012,
Abstract: Se presenta una paciente de sexo femenino, de 9 a os de edad, que acude a su médico de familia y se le auscultó un soplo al examen físico y sintomatología que se comportaba como una comunicación interventricular. Luego de los estudios correspondientes, se permitió hacer el diagnóstico de transposición corregida de grandes vasos. La paciente tenía asociada una anomalía de Ebstein, comunicación interauricular, una comunicación interventricular, y una persistencia del conducto arterioso, todo lo cual agravaba su cuadro clínico. Primero es intervenida quirúrgicamente, y se cierra el ducto; de manera espontánea, cierra la comunicación interauricular, y la anomalía de Ebstein parchea la comunicación interventricular. La ni a desarrolla una insuficiencia cardiaca e hipertensión pulmonar, a consecuencia de las anomalías asociadas. El caso es de interés, ya que son pocos los publicados en la literatura internacional con esta cardiopatía congénita asociada a otras anomalías estructurales del corazón, que modifican su historia natural. This paper presented a 9 years-old female patient, who went to the family's doctor and was physically examined to detect heart murmur and symptoms of ventricular septal defect. After the corresponding studies, the diagnosis was the corrected transposition of the great arteries. The patient also suffered Ebstein anomaly, atrial septal defect, ventricular septal defect and persistence of arteriose duct, all of which worsened her clinical picture. First, she was operated on and the duct was closed. Later the atrial septal defect closed spontaneously, and the Ebstein anomaly patched the ventricular septal defect. The girl developed heart failure and pulmonary hypertension, as a result of associated anomalies. The case is interesting since few cases like this one, associated with other structural heart anomalies that change its natural course, are presented in the international literature.
Ventricular assist device outflow graft in congenitally corrected transposition of great arteries - a surgical challenge  [cached]
Mohite Prashant N,Popov Aron F,Garcia Diana,Hards Rachel
Journal of Cardiothoracic Surgery , 2012, DOI: 10.1186/1749-8090-7-93
Abstract: Congenitally corrected transposition of the great arteries is a complex congenital cardiac anomaly with a wide spectrum of morphologic features and clinical profiles. Most patients are diagnosed late in their life, undergoes surgical repairs, eventually leading to systemic ventricular failure needing heart transplant or mechanical circulatory assistance. As, aorta is located anterior to and left of the PA (Transposition of great arteries), the outflow graft of ventricular assist device traverse across pulmonary artery to reach aorta which poses challenge during further surgical explorations.
Long term follow up after surgery in congenitally corrected transposition of the great arteries with a right ventricle in the systemic circulation
Ad JJC Bogers, Stuart J Head, Peter L de Jong, Maarten Witsenburg, Arie Kappetein
Journal of Cardiothoracic Surgery , 2010, DOI: 10.1186/1749-8090-5-74
Abstract: A total of 32 patients with CCTGA were operated between January 1972 and October 2008. These operations comprised 18 patients with a repair with a normal left ventricular outflow tract, 11 patients with a Rastelli repair of the left ventricle to the pulmonary artery and 3 patients with a cardiac transplantation.Excluding the cardiac transplantation patients, mean age at operation was 16 years (sd 15 years, range 1 week - 49 years). Median follow-up was 12 years (sd 10 years, range 7 days - 32 years). Survival obtained from Kaplan-Meier analysis at 20 years after surgery was 63% (CI 53-73%). For the non-Rastelli group these data at 20 years were 62% (CI 48-76%) and for the Rastelli group 67% (CI 51-83%). Freedom of reoperation at 20 years was 32% (CI 19-45%) in the overall group. In the non-Rastelli group the data at 20 years were 47% (CI 11-83%) and for the Rastelli group 21% (CI 0-54%) after almost 19 years.Long term follow up confirms that surgery in CCTGA with the right ventricle as systemic ventricle has a suboptimal survival and limited freedom of reoperation. Death occurred mostly as a result of cardiac failure.Congenitally corrected transposition of the great arteries (CCTGA) is a rare cardiac anomaly with an incidence of less than 1% of patients with congenital heart disease [1]. Characteristically the right atrium is connected to the morphologically left ventricle, which connects to the pulmonary artery and the left atrium is connected to the morphologically right ventricle, which connects to the aorta, resulting in atrio-ventricular discordance and ventriculo-arterial discordance, or double discordance [2]. In 90% of these patients associated anomalies are present as well, with ventricular septal defect as the most common, followed by pulmonary stenosis and atrial septal defect [1,3-5].The prognosis of patients with CCTGA is variable with some patients showing satisfactory long-term survival [1,5-7]. However, both deteriorating right ventricular function o
Congenitally corrected transposition
Gonzalo A Wallis, Diane Debich-Spicer, Robert H Anderson
Orphanet Journal of Rare Diseases , 2011, DOI: 10.1186/1750-1172-6-22
Abstract: Congenitally corrected transposition of the great arteries, corrected transposition of the great arteries, L-transposition of the great arteries, ventricular inversion.The Baron Rokitansky, in his atlas of 1875, was the first to describe the entity we now know as congenitally corrected transposition (Figure 1). It is also known as "L-transposition" or ventricular inversion, although, as we will describe, these terms are less than precise.The essence of the lesion is the combination of discordant atrioventricular and ventriculo-arterial connections (Figure 2 and Figure 3). Thus, the morphologically right atrium is connected to a morphologically left ventricle across the mitral valve, with the left ventricle then connected to the pulmonary trunk (Figure 4). The morphologically left atrium is connected to the morphologically right ventricle across the tricuspid valve, with the morphologically right ventricle connected to the aorta (Figure 5). When the atrial chambers are arranged in their usual fashion, the morphologically left ventricle is usually positioned to the right, and the aorta, arising from the right ventricle, is left-sided. The malformed heart can also be found with the atrial chambers in mirror-image arrangement. In this setting, the morphologically left ventricle is left-sided, and the aorta is typically positioned to the right. Hence, such patients do not have "L-transposition", but do have congenitally corrected transposition.Congenitally corrected transposition is also described as "double discordance". As the name implies, the discordant connections at both the atrioventricular and ventriculo-arterial junctions results in normal physiology - hence the congenital correction of the transposition. Because of the double discordance, the systemic venous return is pumped to the lungs, while the pulmonary venous return is directed to the body. Symptoms are produced not by the segmental arrangement of the cardiac components, but by the presence of associated
Atrial Fibrillation-Induced Cardiac Shock: First Manifestation of a Congenitally Corrected Transposition of the Great Arteries in a 45-Year-Old Man  [PDF]
M. Graf,M. Zaczkiewicz,J. Torzewski,O. Zimmermann
Case Reports in Cardiology , 2012, DOI: 10.1155/2012/126764
Abstract: Background. The congenitally corrected transposition of the great arteries (L-TGA) is a very rare congenital heart defect, which often remains undetected for several decades of life. Case Presentation. We report on a 45-year-old man without prior history of heart disease, presenting with cardiac shock related to a first episode of tachycardic atrial fibrillation. The diagnostic work-up identified a L-TGA as the underlying cause for acute heart failure. Discussion. L-TGA is a very rare congenital heart defect, which is characterized by an atrioventricular as well as a ventriculoarterial discordance. By this means, the physiological sequence of pulmonary and systemic circulation is still maintained. On the basis of an ongoing strain of the right ventricle, which has to carry the burden of the systemic blood pressure, after more than four decades without symptoms, acute heart failure was triggered by a tachycardic atrial fibrillation. 1. Introduction The congenitally corrected transposition of the great arteries (L-TGA) is a very rare congenital heart defect that represents less than 1% of all congenital heart disorders [1]. In many cases, these patients remain asymptomatic for several decades of life. We report the case of a 45-year-old man, who was admitted to our emergency unit due to haemodynamic instable tachycardic atrial fibrillation. Further diagnostics revealed an—so far unknown—L-TGA. 2. Case Presentation A 45-year-old man was admitted to our emergency unit because of rapidly increasing dyspnoea and pulmonary rales. The patient’s history lacked previous significant illnesses, particularly structural heart or lung diseases and cardiovascular risk factors. The patient described himself up to now as sportive and physically trained, but remarked a general weakness within the last couple of weeks. Since 48?h he sensed palpitations which had now ended up in tachycardia. The electrocardiogram (ECG) showed tachycardic atrial fibrillation with a mean heart rate of 160?bpm. The initial systolic blood pressure amounted not more than 80?mmHg. Under the clinical presentation of acute heart failure, we immediately performed an electrical cardioversion. After two attempts with biphasic application of 150 and 200?Joule of energy, a normofrequent sinus rhythm could be established. Intermitting short episodes of an AV-junctional rhythm were observed. Even now, the patient still showed signs of an ongoing cardiac shock and remained dependent on constant dobutamine supply. Although an ameliorated spontaneous breathing was reported, orthopnoea persisted under the
Midterm results after arterial switch operation for transposition of the great arteries: a single centre experience  [cached]
Popov Aron Frederik,Tirilomis Theodor,Giesler Michael,Oguz Coskun Kasim
Journal of Cardiothoracic Surgery , 2012, DOI: 10.1186/1749-8090-7-83
Abstract: Background The arterial switch operation (ASO) has become the surgical approach of choice for d-transposition of the great arteries (d-TGA). There is, however an increased incidence of midterm and longterm adverse sequelae in some survivors. In order to evaluate operative risk and midterm outcome in this population, we reviewed patients who underwent ASO for TGA at our centre. Methods In this retrospective study 52 consecutive patients with TGA who underwent ASO between 04/1991 and 12/1999 were included. To analyze the predictors for mortality and adverse events (coronary stenoses, distortion of the pulmonary arteries, dilatation of the neoaortic root, and aortic regurgitation), a multivariate analysis was performed. The follow-up time was ranged from 1–10 years (mean 5 years, cumulative 260 patient-years). Results All over mortality rate was 15.4% and was only observed in the early postoperative period till 1994. The predictors for poor operative survival were low APGAR-score, older age at surgery, and necessity of associated surgical procedures. Late re-operations were necessary in 6 patients (13.6%) and included a pulmonary artery patch enlargement due to supravalvular stenosis (n = 3), coronary revascularisation due to coronary stenosis in a coronary anatomy type E, aortic valve replacement due to neoaortic valve regurgitation (n = 2), and patch-plasty of a pulmonary vein due to obstruction (n = 1). The dilatation of neoaortic root was not observed in the follow up. Conclusions ASO remains the procedure of choice for TGA with acceptable early and late outcome in terms of overall survival and freedom of reoperation. Although ASO is often complex and may be associated with morbidity, most patients survived without major complications even in a small centre.
Rheumatic “Taussig-Bing Heart”: A Case Report  [PDF]
Ramachandran Muthiah
Case Reports in Clinical Medicine (CRCM) , 2018, DOI: 10.4236/crcm.2018.71002
Abstract: Aim: To report a case of acyanotic Taussig-Bing heart, anatomically consistent with L-transposition and rheumatic Left AV valve regurgitation associated with complete AV block in an adolescent male. Introduction: Taussig-Bing heart is one of the conotruncal malformation, characterized by double-outlet right ventricle (DORV) and a subpulmonary VSD. Embryologically, abnormal cardiac looping with malalignment of conotruncal septum result its complexity and great artery relationships. Case Report: A 14-year old acyanotic boy presented with severe left-sided AV valve regurgitation and bradycardia. ECG revealed left sided morphologic right ventricular hypertrophy (RVH) as evidenced by a loss of septal Q waves in left precordial leads suggesting ventricular inversion. X-ray chest revealed a straight upper right cardiac border due to loss of normal relationship of great vessels and cardiomegaly due to both left atrial and morphologic right ventricular enlargements suggesting a left-sided regurgitant lesion. Echocardiography revealed the ventricular inversion, primary origin of both L-transposed great arteries from the left-sided morphologic right ventricle suggesting a “double-outlet morphologic right ventricle” with “double discordance” and a subpulmonary VSD of Taussig-Bing type. The left-sided morphologic tricuspid valve is severely regurgitant due to rheumatic process resulting in heart failure which was improved with anti-failure measures and penicillin prophylaxis. Conclusion: The presence of left-sided regurgitation associated with bradycardia is a suspicion of “double discordance” and “double switch” procedure remains the mainstay of its surgical correction. Left AV valve replacement with intraventricular repair is preferred in this child since the malformation is consistent with Taussing-Bing type of DORV with L-transposition.
Page 1 /100
Display every page Item


Home
Copyright © 2008-2017 Open Access Library. All rights reserved.