Transposition of Great Arteries
Definition
Epidemiology
3-5% of all congenital cardiac lesions, most common cyanotic CHD in neonate
Clinical Features
Signs
Investigations
Treatment
Source
Toronto Notes 2012
- Parallel pulmonary and systemic circulations
- Systemic: body --> RA --> RV --> aorta --> body
- Pulmonary: lungs --> LA --> LV --> pulmonary artery --> lungs
Epidemiology
3-5% of all congenital cardiac lesions, most common cyanotic CHD in neonate
Clinical Features
Signs
- No murmur if no VSD
- Progressive cyanosis
- Severe hypoxemia,
- Acidosis, and death can occur rapidly
- VSD present, cyanosis is not prominent and infant presents with CHF after a few weeks of life
Investigations
- ECG: RAD, RVH
- CXR: egg-shaped heart with narrow mediastinum ("egg on a string")
Treatment
- Prostaglandin E1 Infusion to keep ductus open until septostomy or surgery (arterial switch procedure)
- Infants without VSD must be repaired within 2 wks to avoid weak LV muscle
Source
Toronto Notes 2012