Congenitally corrected transposition of the great arteries

Area of Science:

• Cardiology
• Medical Imaging
• Fetal Medicine

Background:

• Congenitally corrected transposition of the great arteries (cTGA) is an uncommon congenital heart malformation.
• cTGA involves discordant atrioventricular and ventriculoarterial connections, often with associated anomalies.
• Prenatal detection of cTGA can be challenging due to subtle presentations and mimicry of other conditions like complete TGA.

Purpose of the Study:

• To report a case of in utero diagnosis of cTGA.
• To emphasize the diagnostic utility of specific echocardiographic views for cTGA.
• To highlight the importance of identifying cTGA prenatally, even in the absence of other cardiac defects.

Main Methods:

• Fetal echocardiography at 29 weeks' gestation.
• Detailed examination of the four-chamber view to assess atrioventricular connections.
• Assessment of the spatial relationship of the great vessels.

Main Results:

• A diagnosis of cTGA was made prenatally at 29 weeks' gestation.
• No additional cardiac anomalies were identified prenatally.
• Postnatal findings included a patent ductus arteriosus with bidirectional flow.

Conclusions:

• Accurate prenatal diagnosis of cTGA is possible with careful echocardiographic assessment.
• Identifying atrioventricular discordance and the parallel course of great vessels (l-transposition) are key.
• Early prenatal diagnosis of cTGA facilitates timely postnatal management.