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Anatomical correction of complete transposition of the great arteries and ventricular septal defect in infancy
Insights
This study demonstrates that early anatomical correction for D-transposition of great arteries with ventricular septal defect is feasible. Surgical repair improved cyanosis and heart failure in two pediatric patients.
Area of Science:
- Pediatric Cardiac Surgery
- Congenital Heart Disease Management
- Cardiovascular Surgery
Background:
- D-transposition of great arteries (dTGA) with large ventricular septal defect (VSD) presents complex surgical challenges.
- Effective management strategies for infants and children with dTGA and VSD are crucial for improving outcomes.
Observation:
- Two pediatric patients, an 8-week-old infant and a 5-year-old child, with dTGA and VSD underwent surgical correction.
- The procedure involved transecting and reattaching the aorta and pulmonary arteries to their correct ventricles, including coronary artery origins.
- The VSD was repaired via transverse ventriculotomy with a Dacron patch.
Findings:
- Both patients experienced an immediate significant drop in pulmonary artery pressure post-operation.
- Postoperative recovery was satisfactory, with resolution of cyanosis and heart failure in both individuals.
- The surgical technique successfully addressed the anatomical defects in both pediatric cases.
Implications:
- Early anatomical correction for dTGA with VSD is a viable and effective treatment option.
- This surgical approach offers a promising strategy for managing complex congenital heart defects in pediatric patients.
- The findings support the consideration of early surgical intervention for improved long-term outcomes in dTGA and VSD.
Abstract:
Two patients, aged 8 weeks and 5 years, with D transposition of great arteries and large ventricular septal defect were treated by transection of both aorta and pulmonary arteries and reattaching them to the appropriate ventricles. This included the origins of the coronary arteries. The ventricular septal defect was closed through a transverse ventriculotomy using a Dacron patch. The younger child was operated on as an emergency because of cyanosis and severe heart failure resistant to intensive medical treatment. The older child had had previous banding of the pulmonary artery at the age of 1 year. In both patients pulmonary artery pressure dropped to below half systemic pressure immediately after the operation. Postoperative progress was satisfactory with relief of cyanosis and heart failure. Early anatomical correction of transposition of the great arteries and ventricular septal defect is feasible and should play an important part in the management of these patients.