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February 26 2015

TOGV

Write short notes on transposition of great vessels

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Neuros
Neuros
February 26 2015 #

Transposition of great vessels is a congenital cyanotic heart defect characterised by abnormal arrangement of the great vessels. When only the aorta and the pulmonary artery are involved, where the aorta originates from the right ventricle and the pulmonary artery from the left ventricle - it is called as transposition of great arteries. 

These conditions have an underlying patent ductus arteriosus, artial septal defect or a ventricular septal defect. These defects are essential in providing oxygenation to the blood. 

Risk factors:

  • Diabetic mothers
  • Rubella during pregnancy
  • Maternal age over 40 years
  • Alcohol intake during pregnancy

Clinical Picture:

  • Seen in early neonatal period
  • Cyanosis
  • Shortness of breath
  • Fatigue and failure to thrive
  • Single S2 heart sound

Investigations:

  • Chest xray - shows an egg on sting appearance
  • Echocardiography - locate position of aorta and pulmonary arteries
  • ECG
  • Cardiac catherization

Treatment:

  • Administer prostaglandin E1 to keep the PDA open
  • Surgical correction of the defect (Atrial switch operation); usually two surgeries are necessary

References:

  1. Mayo Clinic: Transposition of Great arteries (Accessed 26 Feb 2015)
  2. Conrad Fischer. Master the boards for USMLE Step 2 (2010). Pediatrics: Cyanotic Lesions (pg 413)