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Dynamic outflow tract obstruction in congenitally corrected transposition of the great arteries

Andrew O Zurick1, Venu Menon

  • 1Heart & Vascular Institute, Department of Cardiovascular Medicine, Cleveland Clinic, Desk J1-5, Cleveland, OH 44195, USA. Zuricka@ccf.org

The International Journal of Cardiovascular Imaging
|March 2, 2010
PubMed

Insights

Congenitally corrected transposition of the great arteries (CCTGA) is a rare heart defect. This case highlights severe complications and challenges in surgical treatment for adult CCTGA patients.

Area of Science:

  • Cardiology
  • Congenital Heart Disease
  • Cardiac Surgery

Background:

  • Congenitally corrected transposition of the great arteries (CCTGA) is a rare congenital heart defect, affecting 0.5% of cases.
  • Left ventricle outflow tract obstruction is a common complication in CCTGA, occurring in 44-57% of patients.

Observation:

  • A 45-year-old woman with CCTGA presented with worsening dyspnea and severe tricuspid regurgitation.
  • Imaging revealed severe right ventricle dysfunction and dynamic left ventricle outflow tract obstruction due to mitral valve systolic anterior motion and a ventricular septal aneurysm.

Findings:

  • The patient exhibited severe systemic ventricle (morphologic right ventricle) contractile dysfunction.
  • Dynamic non-systemic ventricle (morphologic left ventricle) outflow tract obstruction was identified, caused by systolic anterior motion of the mitral valve and a ventricular septal aneurysm.

Implications:

  • Surgical correction was deemed too high-risk for this patient.
  • Medical therapy was pursued as the primary treatment course for this complex adult CCTGA case.

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