Transposition of the great arteries
Umberto Squarcia1, Chiara Macchi
1Dipartimento dell'età evolutiva, Cattedra di Cardiologia Pediatrica, Università degli Studi di Parma, Italy. umberto.squarcia@unipr.it
Current Opinion in Pediatrics
|August 19, 2011
Summary
This review explores similarities between heart development and snail shells, introduces a new noninvasive method for assessing pulmonary vascular resistance in transposition of the great arteries (TGA), and discusses outcomes for women after arterial switch operation (ASO).
Area of Science:
- Embryological development of congenital heart defects.
- Comparative anatomy of cardiac and shell morphogenesis.
- Genetics of conotruncal anomalies.
Background:
- Transposition of the great arteries (TGA) is a complex congenital heart defect.
- Understanding embryological origins may reveal common genetic mechanisms.
- Similarities between spiral patterns in great arteries and snail shells are noted.
Purpose of the Study:
- To examine similarities between spiral patterns of great arteries and snail shells.
- To review new diagnostic methods and treatment outcomes for TGA.
- To discuss management of the failing systemic right ventricle (RV).
Main Methods:
- Review of embryological cardiac development.
- Assessment of pulmonary vascular resistances using a novel noninvasive method.
- Analysis of pregnancy outcomes in women post-arterial switch operation (ASO).
Main Results:
- Astonishing similarities found between cardiac and shell development.
- A new noninvasive method for assessing pulmonary vascular resistance in TGA and VSD is proposed.
- Initial pregnancy outcomes after ASO are promising.
- Treatment strategies for the failing systemic RV are debated.
- Rastelli operation results are compared with alternative surgical interventions.
Conclusions:
- Embryological cardiac development shows similarities to shell development.
- A new noninvasive diagnostic tool for pulmonary vascular resistance is presented.
- Positive pregnancy outcomes after ASO offer encouragement.
- The Rastelli operation remains a gold standard for TGA, VSD, and pulmonary stenosis.
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