Imaging the adult with transposition of the great arteries

Area of Science:

• Cardiology
• Medical Imaging
• Congenital Heart Disease

Background:

• Transposition of the great arteries (TGA) is a congenital heart defect where the aorta and pulmonary artery are switched.
• Patients with TGA often survive into adulthood, presenting with various long-term complications.

Purpose of the Study:

• To review the clinical sequelae in adults with complete and congenitally corrected TGA.
• To highlight the role and limitations of echocardiography in assessing these patients.
• To emphasize the need for a comprehensive imaging strategy.

Main Methods:

• Review of current literature on adult TGA management and imaging.
• Focus on echocardiography as the primary modality.
• Identification of limitations and complementary imaging techniques.

Main Results:

• Echocardiography provides essential anatomic and hemodynamic data for TGA patients.
• Limitations include assessing the systemic right ventricle, baffle patency, coronary arteries, and outflow tract obstruction.
• Specific surgical repairs (atrial switch, arterial switch) lead to distinct long-term issues.

Conclusions:

• Long-term outcomes in TGA are influenced by the type of surgical palliation.
• A multimodality imaging approach, beyond echocardiography, is necessary for complete patient evaluation.
• Integrated imaging strategies improve the management of adult TGA survivors.