Congenital transposition of the great arterial trunks

Abstract

In this study, five cases of transposition of the arterial trunks are presented (Table I). There are four cases of complete transposition according to the older classification of Rokitansky, and one case of partial transposition of the arterial trunks. Thus, according to Spitzer's more recent classification there are four cases of group III, representing a lack of torsion of the arterial trunks, and one case of group II, representing partial torsion. The youngest patient was eighteen days of age and the oldest lived for seven months. In four of the five cases, the ductus arteriosus was patent but in one case it was represented by a mere fibrous cord and there was dimpling of the intimal surface of the pulmonary artery and aorta over the respective points of junction with the ductus arteriosus. In one case the foramen ovale was closed by a thin membrane, and it was but a slitlike opening in another case. The interventricular septum was intact in three of the five cases and patent in two of them. The patency was attributable to an absence of the membranous portion of the septum. Systolic murmurs were audible in four of the five cases, but the patency of the fetal passages might well account for these murmurs. In two cases there was associated situs inversus. In four of the five cases the diagnosis of congenital heart disease was made without qualification before the patient died. The electrocardiogram indicated the presence of auriculoventricular dissociation in one case in which an interventricular septal defect existed.