D-transposition of the great arteries—a new era in cardiology

In the current issue of Cardiovascular Innovations and Applications , Angeline D. Opina and Wayne J. Franklin from the Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA consider the D-transposition of the great arteries.

D-transposition of the great arteries (d-TGA) is the second most common cyanotic congenital heart disease (CHD) lesion, accounting for 3-5% of all CHD, with a prevalence of 3 per 10,000 live births in the United States. Characterized by concordant atrioventricular connections and discordant ventriculoarterial connections, the aorta arises from the right ventricle, with the pulmonary artery arising from the left ventricle. This results in two parallel circuits. The “systemic” circuit returns deoxygenated blood from the systemic veins to the aorta by way of the right atrium and systemic right ventricle. The “pulmonary” circuit carries oxygenated blood from the lungs to the left atrium before it is pumped to the pulmonary arteries via the subpulmonic left ventricle. Associated congenital cardiac lesions include ventricular septal defects (VSDs) in 45% of cases, left ventricular outflow tract obstruction in 25% of cases, and coarctation of the aorta in 5% of cases. Intracardiac shunting, which can occur at the atrial, ventricular, or ductal level, allows mixing of deoxygenated and oxygenated blood, and is required to sustain life.

Source: Read Full Article