Abstract
Transposition of great arteries (TGA) presents in neonates or in infancy. We report a case of TGA with ventricular septal defect (VSD) and pulmonary stenosis (PS) in an adult male patient of 23 years age. Arterial switch operation with VSD closure and neo-aortic valve replacement was done. The patient recovered well in the post-operative period. In adult patients, conversion from atrial to arterial switch has been widely reported, both directly and after prior pulmonary artery banding in two stages, but primary arterial switch for TGA has not been reported previously. In this patient there was a benefit of having a large VSD and severe PS.
Highlights
Transposition of great arteries (TGA) presents in neonates or in infancy[1]
Echocardiography revealed ventriculoarterial discordance: aorta arising from right ventricle (RV) and pulmonary artery (PA) from left ventricle (LV); aorta found to the right and anterior to PA; evidence of severe valvular pulmonary stenosis (PS), with large sub-pulmonic ventricular septal defect (VSD); normal biventricular function
Peroperative findings were as follows: aorta was present anterior to and to the right of PA and arising from RV and PA from LV; moderate sized sub pulmonic VSD; pulmonic valve was bicuspid with calcification; no atrial septal defect (ASD)
Summary
Transposition of great arteries (TGA) presents in neonates or in infancy[1]. Recently, we managed an adult patient with cyanotic congenital heart disease [TGA with sub pulmonic ventricular septal defect (VSD) with severe pulmonary stenosis (PS)] with complete biventricular repair by performing an arterial switch operation.Case report A 23-year-old man presented with complaints of bluish discoloration of skin and nails from childhood, associated with frequent attacks of pneumonia and dyspnea on exertion, off and on from school going age. We managed an adult patient with cyanotic congenital heart disease [TGA with sub pulmonic ventricular septal defect (VSD) with severe pulmonary stenosis (PS)] with complete biventricular repair by performing an arterial switch operation. Echocardiography revealed ventriculoarterial discordance: aorta arising from right ventricle (RV) and pulmonary artery (PA) from left ventricle (LV); aorta found to the right and anterior to PA; evidence of severe valvular PS (gradient-83 mm Hg), with large sub-pulmonic VSD; normal biventricular function.
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