Abstract
D-TGA is characterized by discordant Ventriculo-arterial connection. For the patient to survive there should be a mixing of the oxygenated and deoxygenated blood at the atrial, ventricular and/or the great vessel level. The hemodynamics of the PFO and ductus arteriosus in D-TGA with intact ventricular septum (VS) is complex and depends upon the relative difference between the pulmonary and systemic vascular resistance as well as the ventricular compliance. D-TGA with intact VS might be associated with persistent pulmonary hypertension as well as with low pulmonary vascular resistance leading to changes in the hemodynamics and direction of flow through the PDA and/or the PFO. The indications of balloon atrial septestomy as well as the initiation and/or the continuation of Prostaglandin infusion are conflicting issues in such cases. We are presenting a case of D-TGA with intact VS who developed steeling and signs of low systemic blood flow because of a large PDA. We reviewed the hemodynamics of PFO and DA in such cases as well as the indications of BAS and PG infusion.
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