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Corrected Transposition of the Great Vessels

Cong Correct Transpos Gt Arts


Presentation

  • We describe the case of a 27-year-old Caucasian woman with corrected transposition of the great vessels, who presented with cardiac failure.[ncbi.nlm.nih.gov]
  • […] with corrected transposition of the great vessels (CTGV) were studied; the first, group A, included 17 patients with CTGV in "situs solitus,", characterized by leftward orientation of the cardiac apex; the second group, group B, with three patients, presented[ncbi.nlm.nih.gov]
  • We present a case of a 21-year-old female with congenitally corrected transposition of the great vessels and episodes of supraventricular tachycardia.[ncbi.nlm.nih.gov]
  • Two consistent observations were made: 1) In no case was the specialized A-V conduction system found in the right atrium, whether or not there was a coronary sinus ostium present. 2) Specialized A-V conduction system electrograms were never delineated[ncbi.nlm.nih.gov]
  • Anteroposterior thoracic roentgenograms may suggest the diagnosis, particularly when a narrow waist is present at the base of the heart, accompanied by the absence of a pulmonary-artery "knob" and the presence of an enlarged left atrium.[pediatrics.aappublications.org]
Cyanotic Congenital Heart Disease
  • Postnatal diagnosis is based on clinical suspicion of cyanotic congenital heart disease and is confirmed with echocardiography (Echo). Electrocardiography (ECG) is typically normal.[pedclerk.bsd.uchicago.edu]
Heart Murmur
  • However, if there are any other associated defects present such as pulmonary stenosis, then your child may have a heart murmur. The sound of extra blood being pushed towards the lungs and leaking through the valve can be heard as a heart murmur.[chfed.org.uk]
  • It might not be diagnosed until well into adulthood when congestive heart failure, heart murmurs and abnormal heart rhythms can develop.[heart.org]
  • Treatment In most cases, a heart murmur leads to further investigation. Diagnosis is by echocardiography. Usually, treatment involves heart catheterisation to open the narrow valve with a balloon.[evelinalondon.nhs.uk]
  • Some babies born with CCTGA have heart murmurs, heart rhythm problems, and/or show signs of heart failure. If they also have a ventricular septal defect (VSD) they may also be cyanotic (blue). In these cases a diagnosis is usually made in infancy.[achaheart.org]
  • Even in the presence of a ventricular septal defect, a heart murmur is often absent in the first days or weeks of life.[cincinnatichildrens.org]
Vascular Disease
  • Disease 1496 Cerebrovascular Disease 1511 Disease of Peripheral Vessels 1531 Renal Artery Disease 1549 Venous Thromboembolism 1569 Index 1585 Genetic Factors in Atherosclerosis 1589 Gene Therapy 1602 حقوق النشر مقاطع مشهورة الصفحة 108 - Heart Association[books.google.com]
  • Learn more » Vascular Surgery Offering comprehensive care of vascular disease through preventive services, diagnostic expertise, minimally invasive therapies and traditional surgical techniques.[surgery.usc.edu]
  • disease 血管病 vasculature血管構造、脈管系 vasoconstriction血管収縮[性] vasodepressor syncope血管抑制性失神 vasodilatation血管拡張 vasomotor reflex血管運動反射 vasospasm血管攣(れん)縮、血管スパズム vasospastic angina (VSA)血管攣(れん)縮性狭心症 vasovagal reaction血管迷走神経反応 vasovagal syncope血管迷走神経性失神 vegetation[tokyo-med.ac.jp]
Stupor
  • In 2011, he was hospitalized in Luxembourg for fever, headache, nausea and non-focal neurological alterations (stupor).[elsevier.pt]

Workup

  • See Workup for more detail. Management Medical care There is little evidence that established medical treatment options for left ventricle dysfunction (ACE inhibitors, beta-blockers, nitrates) produce similar outcomes for systemic right ventricles.[emedicine.medscape.com]
Mediastinal Mass
  • Congenitally-corrected transposition of the great vessels (CTGV) may be detected de novo in adulthood and the plain radiographic findings may be ambiguous or they may be mimicked by a mediastinal mass.[ncbi.nlm.nih.gov]
Third Degree Atrioventricular Block
  • Since the patient had presented periods of third-degree atrioventricular block and was highly pacing-dependent during follow-up ICD consultations prior to hospitalization, and we wished to use the minimum amount of intravascular prosthetic material, a[elsevier.pt]
P Wave Absent
  • Electrocardiographic features that should suggest corrected transposition are atrioventricular block (particularly 2:1 or complete heart block), abnormal P waves, absent or low R voltage in aVR, an initial Q wave in leads 3, aVR, aVF and V 1, absence[pediatrics.aappublications.org]
Prominent A-Wave
  • ECG absence of Q waves in the lateral precordium (V4-6) physiologic Q waves in these leads often referred to as "septal" Q waves prominent Q waves in right precordium (V1-3) third degree atrioventricular (AV) conduction block 9 In this anomaly, the right[radiopaedia.org]
Biventricular Hypertrophy
  • The electrocardiogram (ECG) at rest showed a normal sinus rhythm with precordial ST- segment depression (V2 to V4), T-wave inversion (V2 to V3) and signs of biventricular hypertrophy.[springerplus.springeropen.com]

Treatment

  • الصفحة 24 - Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). ‏ الصفحة 134 - Sacks FM, Pfeffer MA, Moye LA et al.[books.google.com]
  • The treatment for advanced AV block is to have a pacemaker implanted, which stimulates the heart, allowing it to beat fast enough. Symptoms of advanced AV block include: Lightheadedness Fainting Profound fatigue.[nationwidechildrens.org]
  • Surgical treatment of corrected transposition has been difficult because of complete atrioventricular block before or after operation, residual incompetence when deformed left atrioventricular valves were present, and the mirror-image arrangement for[pediatrics.aappublications.org]
  • Treatment Diagnosis and treatment for babies is based on clinical findings (such as weak pulses in the legs) and echocardiography. Typically treatment is surgery, but occasionally heart catheterisation may be the treatment of choice.[evelinalondon.nhs.uk]
  • Introduction: Improved medical and surgical treatment strategies led to a tremendous increase of the incidence of end-stage heart failure which has almost tripled during the past years.[thieme-connect.com]

Prognosis

  • CONCLUSIONS: The long-term prognosis of the double-switch operation for congenitally corrected transposition of the great arteries was acceptable.[ncbi.nlm.nih.gov]
  • Prognosis Left untreated, this disease is fatal within the first weeks of life. Prevention Because there is no identifiable cause, there is no way to prevent this condition. Resources Books Alexander, R. W., R. C. Schlant, and V. Fuster, editors.[medical-dictionary.thefreedictionary.com]
  • Treatment [ edit ] Simple l-TGA has a very good prognosis, with many individuals being asymptomatic and not requiring surgical correction.[en.wikipedia.org]
  • The absence of associated anomalies portends a good overall prognosis, and diagnosis is delayed until later in life in these patients.[consultant360.com]
  • Prognosis Patient prognosis depends on AV conduction, arrhythmias, structural abnormalities, and degree of hemodynamic disturbance. [5] Sudden death may be related to the onset of complete heart block or atrial or ventricular arrhythmias.[emedicine.medscape.com]

Etiology

  • The etiology of the tricuspid valve stenosis and regurgitation was considered rheumatic because of a history of polyarthritis, early presentation, characteristic echocardiographic valve morphology and combined involvement of the tricuspid valve and the[heartviews.org]
  • The oldest individual previously reported in the literature to have survived with this anomaly was 80 years old. 1 The etiology of heart failure in the 91-year-old patient discussed in our article was tricuspid regurgitation, although congestive heart[consultant360.com]
  • Atrioventricular septal defects: possible etiologic differences between complete and partial defects. Teratology, 63, 87-93. PMID: 11241431 3.0.CO;2-5 DOI. Reviews Kutty S, Danford DA, Diller GP & Tutarel O. (2018).[embryology.med.unsw.edu.au]
  • Etiology Causes and exposures associated with congenitally corrected transposition of the great arteries have not been identified clearly. A substantial number of patients with congenital heart disease have a deletion of chromosome band 22q11.[emedicine.medscape.com]

Epidemiology

  • Epidemiology United States data Data from the Baltimore-Washington Infant Study supported the fact that congenitally corrected transposition is a rare disorder. [4] As many as 40 infants per 100,000 live births are affected by congenitally corrected transposition[emedicine.medscape.com]
Sex distribution
Age distribution

Pathophysiology

  • 1243 Percutaneous Coronary Intervention 1258 Percutaneous Cardiac Procedures 1273 Coronary Artery Bypass Surgery 1290 Approaches to the Patient with Prior Bypass Surgery 1306 Percutaneous Valve Dilatations 1316 Global Pandemic of Heart Failure 1330 Pathophysiology[books.google.com]
  • (Click picture to show/hide bloodflows) Pathophysiology The physiology of "corrected" transposition of the great vessels is related to the associated defects.[vhlab.umn.edu]
  • Pathophysiology, clinical manifestations, and diagnosis of Dtransposition of the great arteries.” UptoDate Jan 19, 2011. Fulton, David R; Kane, David A. “Management and outcome of D-transposition of the great arteries.” UptoDate Oct 18, 2011.[pedclerk.bsd.uchicago.edu]
  • Pathophysiology Congenitally corrected transposition of the great vessels is a rare congenital heart defect associated with multiple cardiac morphologic abnormalities and conduction defects.[emedicine.medscape.com]

Prevention

  • Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. ‏[books.google.com]
  • Advantages of this over atrial switch are anatomical correction of discordant ventriculoarterial connections, reduced incidence of rhythm disturbances, prevention of the development of right ventricular failure. [4] However, neo-aortic root dilation,[saudija.org]
  • If you are trying to prevent pregnancy, you will need to select the lowest risk form of birth control. In most cases, the cause of a congenital heart defect is not known.[nationwidechildrens.org]
  • While use of ICDs for secondary prevention is generally accepted, implantation for primary prevention remains a topic of great scrutiny.[innovationsincrm.com]
  • Prevention Because there is no identifiable cause, there is no way to prevent this condition. Resources Books Alexander, R. W., R. C. Schlant, and V. Fuster, editors. The Heart. 9th ed.[medical-dictionary.thefreedictionary.com]

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