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A 63-Year-Old Male with D-Transposition of the Great Arteries Who Had an Early Form of the Arterial Switch Operation
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作者 Michael A.Rebolledo Jane S.Yao +2 位作者 Jason N.Johnson Umar S.Boston Benjamin R.Waller III 《Congenital Heart Disease》 SCIE 2024年第1期65-68,共4页
We describe a 63-year-old male who appears to have undergone an early form of the arterial switch operation for D-transposition of the great arteries performed in the mid-1960s.We review the clinical and imaging data ... We describe a 63-year-old male who appears to have undergone an early form of the arterial switch operation for D-transposition of the great arteries performed in the mid-1960s.We review the clinical and imaging data that support our conclusion.He had a diagnostic cardiac catheterization which demonstrated severe pulmonary hypertension responsive to epoprostenol and oxygen.Our case may represent one example of the experimental surgical work done prior to Dr.Adibe Jatene’s description of thefirst successful arterial switch performed in 1975. 展开更多
关键词 Adult congenital heart disease arterial switch operation great vessel anomaly imaging(all modalities)
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Isolation of the Left Subclavian Artery in D-Transposition of the Great Arteries with Right Aortic Arch
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作者 Kotaro Hine Kohei Ogata +3 位作者 Keiko Saitou Norio Mizukaki Hiroko Arai Hitoshi Yoda 《Congenital Heart Disease》 SCIE 2021年第4期369-371,共3页
Abnormal branching of the aorta associated with the right aortic arch(RAA)has been reported as isolation of left subclavian artery(ILSA),isolation of left common carotid artery,isolation of brachiocephalic artery.ILSA... Abnormal branching of the aorta associated with the right aortic arch(RAA)has been reported as isolation of left subclavian artery(ILSA),isolation of left common carotid artery,isolation of brachiocephalic artery.ILSA is a rare aortic branch anomaly that originates in the left subclavian artery from the pulmonary artery via ductus arteriosus.Several reports have described ILSA associated with 22q11.2 deletion syndrome and tetralogy of Fallot.Here,we present a very unusual case of RAA with ILSA associated with D-transposition of the great arteries and inferior vena cava interrupted with azygos continuation. 展开更多
关键词 Isolated left subclavian artery transposition of the great arteries RAA ILSA
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D-Transposition of the Great Arteries:A New Era in Cardiology
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作者 Angeline D.Opina Wayne J.Franklin 《Cardiovascular Innovations and Applications》 2018年第B05期85-92,共8页
Before the 1950s,D-transposition of the great arteries was associated with nearly 90% mortality within the first year of life.The Mustard and Senning procedures resulted in a signifi cant increase in the lifespan of t... Before the 1950s,D-transposition of the great arteries was associated with nearly 90% mortality within the first year of life.The Mustard and Senning procedures resulted in a signifi cant increase in the lifespan of these patients but with notable long-term complications,including arrhythmias,sinus node dysfunction,chronotropic incompetence,and right ventricular systolic dysfunction.The arterial switch operation(first described by Adib Jatene)initially resulted in nearly universal death.However,the use of coronary buttons for coronary artery translocation has improved operative survival dramatically.It is now considered the treatment of choice in patients amendable to the arterial switch operation.Considered an anatomic repair,resulting in concordant ventriculoarterial connections and a systemic left ventricle,the arterial switch operation reduces the incidence of ventricular dysfunction.However,it is also associated with long-term complications,including aortic root dilatation,aortic valve regurgitation,right ventricular outfl ow tract obstructions,coronary artery stenosis/compression,and branch pulmonary artery stenosis. 展开更多
关键词 TRANSPOSITION of the great arteries MUSTARD PROCEDURE Senning PROCEDURE ATRIAL switch operation adult congenital heart disease
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ARTERIAL SWITCH OPERATION FOR COMPLETE D-TRANSPOSITION OF THE GREAT ARTERIES: SURGICAL RESULTS AND ANALYSIS
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作者 徐志伟 杜欣为 +1 位作者 苏肇伉 丁文祥 《Journal of Shanghai Second Medical University(Foreign Language Edition)》 2008年第1期24-27,共4页
Objective To review and analyze the surgical results of arterial switch operations in complete D-transposition of the great arteries (TGA). Methods A total of 113 patients underwent arterial switch operation from Jan.... Objective To review and analyze the surgical results of arterial switch operations in complete D-transposition of the great arteries (TGA). Methods A total of 113 patients underwent arterial switch operation from Jan. 2001 to Dec. 2005. There were 60 patients with transposition of the great arteries and intact ventricular septum (TGA/IVS) and 53 patients with transposition of the great arteries and ventricular septal defect (TGA/VSD). The lowest body weight was 2.3 kg and the smallest age was 6 h. The arterial switch operation was performed under deep hypothermia with circulatory arrest and low-flow perfusion. Results The total mortality was 9.73%. There were 5 deaths in TGA/IVS (8.3%), 6 deaths in TGA/VSD (11.3%). With the development of surgical technique, peri-operative management and cardiopulmonary bypass, the total mortality significantly decreased from 16.65% in the early times to 5.5% lately. Conclusion The vital risk of the operation is coronary artery malformation. The incidence of coronary artery malformation is higher in TGA/VSD than in TGA/IVS. The positional relationship of the great arteries does not affect the results of the operation. The arterial switch operation should be prevented when the pressure ratio between the left and right ventricle is less than 0.6, otherwise it is great likely to cause severe low cardiac output postoperatively. 展开更多
关键词 动脉 转换 手术 冠状动脉
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D-Transposition of Great Arteries in a Primigravida of 35 Years Old-Case Report and Literature Review
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作者 Ali Kassen Omais Camila Martines Mello +6 位作者 Nathalia Suzan Camarao Martins Natália Regina Alécio Mettelo Diehl Alethéia Carpine Favini Schefer Felipe Amorim Zarour Julio Cesar de Oliveira Janice Lanzarin Gisele do Couto Oliveira 《Journal of Pharmacy and Pharmacology》 2018年第7期674-678,共5页
关键词 大动脉 文学评论 盒子 怀孕期 高血压 产科学 案例 胎儿
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Anatomic Correlates of Mitral Systolic Anterior Motion in Transposition of the Great Arteries Following Atrial Switch Operation
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作者 Norman Aiad Mark V.Sherrid +7 位作者 Adam J.Small Youssef Elnabawi Jodi Feinberg Leon Axel Ralph Mosca T.K.Susheel Kumar Michael Argilla Dan G.Halpern 《Congenital Heart Disease》 SCIE 2023年第3期267-277,共11页
Introduction:We sought to investigate whether the development of sub-pulmonic systolic anterior motion(SAM)may be inherent to the anatomy of the the mitral valve(MV)or affected by external factors,such as a dilated ri... Introduction:We sought to investigate whether the development of sub-pulmonic systolic anterior motion(SAM)may be inherent to the anatomy of the the mitral valve(MV)or affected by external factors,such as a dilated right ventricle or chest abnormalities in d-looped transposition of the great arteries post atrial switch operation(d-TGA/AtS).Methods:Analysis was performed of clinical and cardiac imaging studies acquired on 19 adult patients with d-TGA/AtS(age 42±6 years old,56%male)between 2015–2019.Echocardiography data included mitral apparatus anatomy,and CT/MRI data included biventricular dimensions,function,and Haller index(HI)for pectus deformity.Results:Patients with leaflet SAM(n=6)compared to patients without SAM(n=13)had higher MV protrusion height(2.3±0.5 vs.1.5±0.4 cm,p≤0.01)and longer anterior MV leaflet length(3.1±0.4 cm vs.2.6±0.3 cm p≤0.05),when compared to those without.CT/MRI showed higher sub-pulmonic left ventricular ejection fraction(LVEF)in the SAM group(71%±8%vs.54%±7%,respectively).RV size and function,significant chest deformity(HI>3.5),presence of a ventricular lead pacemaker,and septal thickness did not play a role in development of SAM.Conclusions:An elongated mitral apparatus is associated with the development of SAM,and the development of left ventricular outflow tract obstruction(LVOTO),in d-TGA/AtS.LV hyperkinesia is associated with SAM.Systemic RV dimensions,septal thickness,and degree of chest deformity did not differ significantly between subjects with SAM and those without. 展开更多
关键词 d-loop transposition of the great arteries mustard operation senning operation systolic anterior motion of the mitral valve ECHOCARDIOGRAPHY cardiac MRI
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Systemic right ventricle complications in levo-transposition of the great arteries: A case report and review of literature
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作者 Mohamed Ramzi Almajed Abdulla Almajed +2 位作者 Naoshin Khan Mark S Obri Karthikeyan Ananthasubramaniam 《World Journal of Cardiology》 2023年第10期542-552,共11页
BACKGROUND Congenitally corrected levo-transposition of the great arteries(L-TGA)is a congenital heart disease in which the ventricles and great arteries are transposed from their typical anatomy.In L-TGA,the double d... BACKGROUND Congenitally corrected levo-transposition of the great arteries(L-TGA)is a congenital heart disease in which the ventricles and great arteries are transposed from their typical anatomy.In L-TGA,the double discordance,atrioventricular and ventriculoarterial,create an acyanotic milieu which allows patients to survive their early decades,however,progressive systemic right ventricle(sRV)dys-function creates complications later in life.sRV dysfunction and remodeling predisposes patients to intracardiac thrombus(ICT)formation.CASE SUMMARY A 40-year-old male with L-TGA presented with symptoms of acute decom-pensated heart failure.In childhood,he had surgical repair of a ventricular septal defect.In adulthood,he developed sRV dysfunction,systemic tricuspid valve(sTV)regurgitation,and left-bundle branch block for which he underwent cardiac resynchronization therapy.Transthoracic echocardiogram showed a sRV ejection fraction of 40%,severe sTV regurgitation,and a newly identified sRV ICT.ICT was confirmed by ultrasound-enhancing agents and transesophageal echocardio-graphy.Our patient was optimized with guideline-directed medical therapy and diuresis.Anticoagulation was achieved with a vitamin K antagonist(VKA)and he was later referred for evaluation by advanced heart failure and heart transplant services.CONCLUSION Anticoagulation with VKA is the mainstay of treatment in the absence of conclusive data supporting direct oral anticoagulant use in ICT in patients with congenital heart disease.This case illustrates the natural history of L-TGA and highlights the importance of surveillance and monitoring with dedicated cardiac imaging to identify complications. 展开更多
关键词 Levo-transposition of the great arteries Systemic right ventricle Congenital heart disease Intracardiac thrombus ANTICOAGULATION Direct oral anticoagulant Case report
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Coronary Artery Anomalies in D-Transposition of the Great Artery Following Arterial Switch Operation
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作者 Thita Pacharapakornpong Jarupim Soongswang +4 位作者 Chodchanok Vijarnsorn Paweena Chungsomprasong Kritvikrom Durongpisitkul Prakul Chanthong Supaluck Kanjanauthai 《Congenital Heart Disease》 SCIE 2022年第3期297-311,共15页
Background:The survival rate of patients following arterial switch operation(ASO)exceeds 95%,but coronary artery anomalies(CAA)contribute to a 2%incidence of sudden cardiac arrest later in life.Therefore,we aimed to a... Background:The survival rate of patients following arterial switch operation(ASO)exceeds 95%,but coronary artery anomalies(CAA)contribute to a 2%incidence of sudden cardiac arrest later in life.Therefore,we aimed to assess abnormal findings of coronary arteries in post-ASO patients.Methods:Coronary computed tomography angiography(CCTA)is performed on post-ASO patients who meet institutional criteria.Intraoperative findings of coronary artery patterns were retrospectively reviewed and categorized using the Leiden classification system.Coronary artery anomalies were detected by CCTA and associations with coronary artery compromise were explored.Results:Forty-three patients who had CCTA with a median age of 15.6 years(12–21.3 years)were included in the study.Unusual coronary patterns were identified in 20(46%)patients before ASO.CCTA identified 25 CAA in 22 patients(eleven with prepulmonic course,nine with interarterial course,three with acute take-off angle,and two with significant stenosis).Postoperative CAA was more common in patients with unusual coronary patterns(90%vs.17.4%;p<0.001).Nine patients experienced chest pain and two patients required coronary artery bypass graft.A common ostium of RCA and LAD or LMCA were associated with significant chest pain(OR 14.3%,95%CI 2.5 to 82.3).Conclusions:Coronary artery anomalies in post-ASO are common.All post-ASO patients should have coronary artery imaging before participating in competitive sport and when they reach adolescence.Patients with unusual preoperative coronary artery patterns should undergo coronary artery imaging when feasible.Follow-up imaging studies are indicated in patients with post-operative coronary artery abnormalities. 展开更多
关键词 Coronary artery anomalies arterial switch operation d-transposition of great arteries
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Transposition of the great arteries-a phenotype associated with 16p11.2 duplications?
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作者 Zarmiga Karunanithi Else Marie Vestergaard Mette H Lauridsen 《World Journal of Cardiology》 CAS 2017年第12期848-852,共5页
Genetic analyses of patients with transposition of the great arteries have identified rare copy number variations,suggesting that they may be significant to the aetiology of the disease.This paper reports the identifi... Genetic analyses of patients with transposition of the great arteries have identified rare copy number variations,suggesting that they may be significant to the aetiology of the disease.This paper reports the identification of a 16 p11.2 microduplication,a variation that has yet to be reported in association with transposition of the great arteries.The 16 p11.2 microduplication is associated with autism spectrum disorder and developmental delay,but with highly variable phenotypic effects.Autism and attention deficit disorders are observed more frequently in children with congenital heart disease than in the general population.Neonatal surgery is proposed as a risk factor,but as yet unidentified genetic abnormalities should also be taken into account.Thus,congenital heart abnormalities may constitute a part of the phenotypic spectrum associated with duplications at 16 p11.2.We suggest chromosomal microarray be considered part of the diagnostic work-up in patients with transposition of the great arteries. 展开更多
关键词 TRANSPOSITION of the great arteries COPY number variation Genetics 16p11.2 MICRODUPLICATION
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EVALUATION OF THE SURGICAL PROCEDURE OF CORRECTED TRANSPOSITION OF THE GREAT ARTERIES
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作者 徐志伟 苏肇伉 丁文祥 《Medical Bulletin of Shanghai Jiaotong University》 CAS 1999年第2期113-115,133,共4页
ObjectiFe To evaiuate surgicai procedure of corrected transposition of the great arteries(CTGA). Methods Twenty one patients with CTGA were ropaired from September 1990 to December 1996 Eighteen pattents were correcte... ObjectiFe To evaiuate surgicai procedure of corrected transposition of the great arteries(CTGA). Methods Twenty one patients with CTGA were ropaired from September 1990 to December 1996 Eighteen pattents were corrected by biventricular repair. The ventricular septal delect (VSD) was repaired through the right atrium or anatomic left ventricle in 11 patients and through the anatomic right ventricle in 7 patients. There were atrioventricular valvular regurgitation or one side ventricular hypoplasia in 3 patients. Two patients had Fontan operation and one had bidirectional shunt. Results Five patients (45%, 5/11) had complete atrioventricular block (CAVB) in these cases with VSD repaired through the right atrium or left ventricle, and 3 patients died (27%, 3/11). One patient (14%,1/7) had CA VB which the VSD was repaired through the anatomic right ventricle with only one death. Conclusion CAVB could be prevented by VSD rePair through the anatomic right ventricle. CTGA with pulmonary hypertension must be repaired early to prevent pulmonary vascular disease. Fontan or bidirectional shunt were suggested for complex CTGA with valvular regurgitation or ventricular unbalance. 展开更多
关键词 TRANSPOSITION of the great arteries atrioventricular block FONTAN operation BIDIRECTIONAL SHUNT
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Noninvasive Assessment of Autonomic Cardiovascular Function in Patients after Arterial Switch Operation for Transposition of the Great Arteries
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作者 Joanna Hlebowicz Maja Rooth +2 位作者 Sandra Lindstedt Johan Holm Ulf Thilén 《Surgical Science》 2015年第3期126-132,共7页
Background: Children born with transposition of the great arteries (TGA) must undergo corrective surgery for survival, arterial switch being the standard surgical procedure. The sympathetic innervation of the heart ma... Background: Children born with transposition of the great arteries (TGA) must undergo corrective surgery for survival, arterial switch being the standard surgical procedure. The sympathetic innervation of the heart may be damaged during the operation. This study was designed to determine whether adults who were born with TGA and who had arterial switch operation (ASO) in infancy exhibit denervation of the heart, measured as heart rate variability (HRV) with electrocardiography (ECG). Methods: Nine patients with transposition of the great arteries (four men and five women;mean age 26 ± 1 years) who underwent the ASO at a mean age of 85 ± 35 days, and nine healthy adults (five men and five women;mean age 26 ± 2) were included in the study. Cardiac autonomic nerve function was determined by the variation in RR intervals during maximal deep breathing, monitored by continuous ECG. The mean values were calculated for each group from six inspirations (I) and expirations (E), and the E:I ratios were calculated. Results: The E:I ratio did not differ between patients with an arterial switch and healthy controls (P?= 0.161). Two patients had signs of denervation of the heart up to 30 years after the arterial switch operation. Conclusions: Reinnervation of the heart?may take place in patients who have undergone the ASO in infancy, and these patients would not necessarily suffer from autonomic dysfunction. The HRV, measured by ECG, has the potential to identify arterially switched patients at risk of developing silent myocardial ischemia. 展开更多
关键词 CONGENITAL Heart Disease TRANSPOSITION of the great arteries arterial Switch Operation SYMPATHETIC INNERVATION
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Correction of Corrected Transposition of the Great Arteries Associated with Cardiac Anomalies
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作者 肖诗亮 蔡俊坚 蓝鸿钧 《Journal of Huazhong University of Science and Technology(Medical Sciences)》 SCIE CAS 1995年第4期231-233,共3页
Reported in this paper are 8 cases of corrected transposition of the great arteries associated with anomalies. All the patients underwent the repair of the ventricular septal defect and atrial septal defect, the repla... Reported in this paper are 8 cases of corrected transposition of the great arteries associated with anomalies. All the patients underwent the repair of the ventricular septal defect and atrial septal defect, the replacement of left-side tricuspid valve, the pulmonary valvotomy and the placement of extra-cardiac conduit to the pulmonary trunk respectively with no hospital death after operation.The paper also described the selection of the heart incision, the prevention of injury of the conduction system and indication of the placement of extra-cardiac conduit. 展开更多
关键词 corrected transposition of the great arteries extra-cardiac conduit
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3.0T MR Coronary Angiography after Arterial Switch Operation for Transposition of The Great Arteries-Gd-FLASH Versus Non-Enhanced SSFP.A Feasibility Study
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作者 Kathrine Rydén Suther Charlotte de Lange +7 位作者 Henrik Brun Rolf Svendsmark Bac Nguyen Stig Larsen Bjarne Smevik Arnt Eltvedt Fiane Harald Lauritz Lindberg Einar Hopp 《Congenital Heart Disease》 SCIE 2021年第2期107-121,共15页
Background:Patency of the coronary arteries is an issue after reports of sudden cardiac death in patients with transposition of the great arteries(TGA)operated with arterial switch(ASO).Recent studies give rise to con... Background:Patency of the coronary arteries is an issue after reports of sudden cardiac death in patients with transposition of the great arteries(TGA)operated with arterial switch(ASO).Recent studies give rise to concern regarding the use of ionising radiation in congenital heart disease,and assessment of the coronary arteries with coronary MR angiography(CMRA)might be an attractive non-invasive,non-ionising imaging alternative in these patients.Theoretically,the use of 3.0T CMRA should improve the visualisation of the coronary arteries.The objective of this study was to assess feasibility of 3.0T CMRA at the coronary artery origins by comparing image quality with non-contrast CMRA in ASO TGA patients to healthy age-matched controls,and by comparing image quality with non-contrast CMRA to contrast enhanced CMRA in the patient group.Material and methods:Twelve patients,9-15 years(mean 11.9 years,standard deviation 1.5 years),and 12 age-matched controls(mean 12.7 years,standard deviation 1.7 years)were examined with 3D balanced steady-state free precession(SSFP).Nine of twelve patients had Gadolinium-enhanced fast low-angle shot(Gd-FLASH)performed after SSFP.Image quality at the coronary artery origins was evaluated subjectively with a 10 cm figurative visual analogue scale(fVAS)and objectively by signal-to-noise and contrast-to-noise ratio(SNR,CNR).Results:All,but one,coronary artery origins were identified.No significant difference in image quality scores was found between patients and controls with SSFP(mean values 6.5 cm—9.1 cm in patients and 7.0 cm—8.0 cm in controls,p-values>0.1).With SSFP,intra-observer fVAS mean score was 6.7 cm—8.6 cm and with Gd-FLASH 7.7 cm—8.7 cm.CNR was higher with Gd-FLASH(p<0.03).Intra-observer agreement index(AI)with SSFP was moderate-to-good(0.43–0.71)and with Gd-FLASH good(0.64–0.79)in all origins.Inter-observer AI was good in the left main stem(LMS)with SSFP(0.65).With Gd-FLASH inter-observer AI was good in LMS(0.78)and moderate(0.5)in the left anterior descending artery,but lacking in the other origins though with a good agreement on Bland-Altman plots.Conclusions:Our findings indicate a better,more reproducible image quality with Gd-FLASH than with non-contrast SSFP CMRA on 3.0T for evaluation of the coronary artery origins in ASO TGA children and adolescents. 展开更多
关键词 Magnetic resonance imaging coronary angiography GADOLINIUM transposition of great vessels arterial switch operation
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Diagnosed corrected transposition of great arteries after cesarean section:A case report
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作者 Naoki Ichii Toshiyuki Kakinuma +11 位作者 Atsushi Fujikawa Morihiko Takeda Tomoyuki Ohta Masataka Kagimoto Ayaka Kaneko Ryo Izumi Kaoru Kakinuma Koyomi Saito Asako Maeyama Kaoru Yanagida Nobuhiro Takeshima Michitaka Ohwada 《World Journal of Clinical Cases》 SCIE 2022年第27期9821-9827,共7页
BACKGROUND Corrected transposition of the great arteries(cTGA) is a cardiac malformation in which the ventricular and arterial-ventricular positions in the heart are doubly reversed.In general,this defect puts a load ... BACKGROUND Corrected transposition of the great arteries(cTGA) is a cardiac malformation in which the ventricular and arterial-ventricular positions in the heart are doubly reversed.In general,this defect puts a load on the systemic circulation and causes heart failure,resulting in a poor prognosis.This article reports a case of cTGA detected in a patient with post-caesarean pregnancy who had undergone elective caesarean section and was experiencing an episode of acute heart failure.CASE SUMMARY This was the case of a 36-year-old gravida 3 para 1 woman.No problems were noted in the puerperal course following the previous pregnancy.The current pregnancy was also uneventful.An elective caesarean section was performed and the patient was discharged from the hospital 7 d after the operation.On postoperative day 18,the patient became aware of breathing difficulty and presented at a nearby clinic,where she was referred to our institution after bilateral pleural effusions were detected.She was then diagnosed with acute heart failure after noting the presence of a prominent pedal oedema and SpO_(2) 91%(supine position and room air);the patient was promptly hospitalised for close examination and treatment.Although chest computed tomography revealed the presence of cTGA,no other cardiac malformations were observed.Owing to improvements in both the pedal oedema and pleural effusions,the patient was discharged on day 9.CONCLUSION Close examination should be performed on the premise of congenital cardiac malformation when heart failure symptoms are noted during perinatal control. 展开更多
关键词 Corrected transposition of the great arteries PREGNANCY Puerperal period Tricuspid insufficiency Case report
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Implantation of an S-ICD in a Patient with a DDD Pacemaker and Congenitally Corrected Transposition of the Great Arteries
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作者 Yu Zhang Wen-Long Dai +2 位作者 Can-Can Lin Qiao-Yuan Li Cheng-Jun Guo 《Cardiovascular Innovations and Applications》 2021年第1期207-212,共6页
Subcutaneous implantable cardioverter-defi brillator(S-ICD)therapy has become a viable alternative to conventional transvenous ICD implantation.Patients with congenitally corrected transposition of the great arteries(... Subcutaneous implantable cardioverter-defi brillator(S-ICD)therapy has become a viable alternative to conventional transvenous ICD implantation.Patients with congenitally corrected transposition of the great arteries(ccTGA)have a high risk of sudden cardiac death due to malignant arrhythmia.The interaction between the S-ICD system and the transvenous pacemaker system is not fully understood.We report a case of S-ICD implantation in a patient with ccTGA and a DDD pacemaker.The patient was a 30-year-old man with a previously placed pacemaker with diagnoses of congenital heart disease,ccTGA(SLL),left atrioventricular valve insuffi ciency,and third-degree atrioventricular block.He presented with an out-of-hospital cardiac arrest,and an S-ICD was implanted to prevent sudden cardiac death.Defi brillation checks were performed successfully.We tested the compatibility of the DDD pacemaker with the S-ICD and found that there was no interference between them.In conclusion,an S-ICD system is a reasonable and safe option in patients with ccTGA. 展开更多
关键词 Subcutaneous implantable cardioverter-defi brillator congenitally corrected transposition of the great arteries PACEMAKER
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Systematic review and meta-analysis of outcomes of anatomic repair in congenitally corrected transposition of great arteries
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作者 Arka Chatterjee Neal J Miller +2 位作者 Marc G Cribbs Amrita Mukherjee Mark A Law 《World Journal of Cardiology》 CAS 2020年第8期427-436,共10页
BACKGROUND Treatment of congenitally corrected transposition of great arteries(cc-TGA)with anatomic repair strategy has been considered superior due to restoration of the morphologic left ventricle in the systemic cir... BACKGROUND Treatment of congenitally corrected transposition of great arteries(cc-TGA)with anatomic repair strategy has been considered superior due to restoration of the morphologic left ventricle in the systemic circulation.However,data on long term outcomes are limited to single center reports and include small sample sizes.AIM To perform a systematic review and meta-analysis for observational studies reporting outcomes on anatomic repair for cc-TGA.METHODS MEDLINE and Scopus databases were queried using predefined criteria for reports published till December 31,2017.Studies reporting anatomic repair of minimum 5 cc-TGA patients with at least a 2 year follow up were included.Metaanalysis was performed using Comprehensive meta-analysis v3.0 software.RESULTS Eight hundred and ninety-five patients underwent anatomic repair with a pooled follow-up of 5457.2 patient-years(PY).Pooled estimate for operative mortality was 8.3%[95%confidence interval(CI):6.0%-11.4%].0.2%(CI:0.1%-0.4%)patients required mechanical circulatory support postoperatively and 1.7%(CI:1.1%-2.4%)developed post-operative atrioventricular block requiring a pacemaker.Patients surviving initial surgery had a transplant free survival of 92.5%(CI:89.5%-95.4%)per 100 PY and a low rate of need for pacemaker(0.3/100 PY;CI:0.1-0.4).84.7%patients(CI:79.6%-89.9%)were found to be in New York Heart Association(NYHA)functional class I or II after 100 PY follow up.Total re-intervention rate was 5.3 per 100 PY(CI:3.8-6.8).CONCLUSION Operative mortality with anatomic repair strategy for cc-TGA is high.Despite that,transplant free survival after anatomic repair for cc-TGA patients is highly favorable.Majority of patients maintain NYHA I/II functional class.However,monitoring for burden of re-interventions specific for operation type is very essential. 展开更多
关键词 Congenitally corrected transposition of great arteries Anatomic repair Double switch operation Atrial switch Rastelli Hemi-Mustard Rastelli Atrio-ventricular block
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Congenitally Corrected Transposition of the Great Arteries: Conduction Anomalies: A Case Report
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作者 Jose Antonio Luna-Alvarez-Amezquita Javier Ivan Armenta-Moreno +6 位作者 Joaquin Berarducci Jorge Luis Bermudez-Gonzalez Jose Luis Siller-Nava Edson Alberto Escandón-Villalobos Nilda Espinola-Zavaleta Roberto Cano-Zarate Juan Ignacio Straface 《World Journal of Cardiovascular Diseases》 2021年第9期439-444,共6页
<strong>Introduction:</strong><span style="white-space:normal;"><span style="font-family:;" "=""> Congenitally corrected transposition of the great arter... <strong>Introduction:</strong><span style="white-space:normal;"><span style="font-family:;" "=""> Congenitally corrected transposition of the great arteries (CCTGA) is a rare heart disease that encompasses an atrioventricular and ventriculoarterial discordance and accounts for less than 1 percent of congenital heart diseases. <b>Objective: </b></span></span><span style="white-space:normal;"><span style="font-family:;" "="">To p</span></span><span style="white-space:normal;"><span style="font-family:;" "="">resent </span></span><span style="white-space:normal;"><span style="font-family:;" "="">an </span></span><span style="white-space:normal;"><span style="font-family:;" "="">atypical case of a man with complex congenital heart disease and conduction anomalies. <b>Case Presentation:</b> This is a case of a 34-year-old patient who came to the hospital with 1 week of dyspnea on exertion and episodes of lipothymia. The patient was referred to our hospital after an electrocardiogram from his primary care with evidence of blocked atrial fibrillation. During the initial evaluation blocked atrial fibrillation was confirmed with a rescue ventricular rate of 38 bpm. A magnetic resonance confirmed the presence of the atrioventricular and ventriculoarterial discordance, the aorta had a left anterior position, perimembranous ventricular septal defect with a right to left shunt, biventricular systolic dysfunction, moderate tricuspid, and mitral regurgitation, interventricular septal intramyocardial and biatrial fibrosis, left</span> </span><span style="white-space:normal;"><span style="font-family:;" "="">atrial dilation, and dilation of the pulmonary artery. After pacemaker placement, the patient has an improvement in his clinical symptoms and quality of life. <b>Conclusions:</b> Cardiac arrhythmias are CCTGA’s leading cause of death, mostly ventricular tachycardia, and atrial fibrillation. Right bundle branch block is a previously unreported and potentially very rare presentation of this disease. This, added to the fact that our patient was diagnosed at an advanced age, but without symptoms of heart failure, makes</span></span><span style="white-space:normal;"><span style="font-family:;" "=""> </span></span><span style="white-space:normal;"><span style="font-family:;" "="">him</span></span><span style="white-space:normal;"><span style="font-family:;" "=""> </span></span><span style="white-space:normal;"><span style="font-family:;" "="">an atypical case of CCTGA, with new potential treatment options.</span></span> 展开更多
关键词 Congenital Heart Disease Congenitally Corrected Transposition of the great arteries Cardiac Magnetic Resonance ECHOCARDIOGRAPHY ARRHYTHMIA
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A 16-day old baby with transposition of great arteries and interrupted aortic arch: a case report
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作者 Li Yang 《Journal of Medical Colleges of PLA(China)》 CAS 2010年第2期122-128,共7页
We report a 16-day-old boy who had transposition of great arteries combined with interrupted aortic arch (IAA). The boy developed cyanotic lips and body bruising 2 h after birth. Color Doppler sonography showed transp... We report a 16-day-old boy who had transposition of great arteries combined with interrupted aortic arch (IAA). The boy developed cyanotic lips and body bruising 2 h after birth. Color Doppler sonography showed transposition of great arteries. The patient underwent total surgical correction of the transfection and defects. We summarized our experience in the perioperative management of the patient, including maintenance of body temperature, close intraoperative monitoring, anesthesia management, cardiopulmonary bypass (CPB) management and so on. 展开更多
关键词 主动脉弓 大动脉 病例报告 转位 婴儿 围手术期 多普勒超声 体外循环
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Quantitative Analysis of Microstructural Components of Human Coronary Arteries
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作者 姜宗来 何光篪 《Journal of Medical Colleges of PLA(China)》 CAS 1989年第4期288-290,381,共4页
The anterior interventricular branch and circumflex of the left coronary artery,the right coronary artery,the internal thoracic artery,and the great saphenous vein were excisedfrom 7 human adult autopsy subjects.Paraf... The anterior interventricular branch and circumflex of the left coronary artery,the right coronary artery,the internal thoracic artery,and the great saphenous vein were excisedfrom 7 human adult autopsy subjects.Paraffin slices of these specimens were prepared and stainedwith different dyes in order to reveal the elastin,collagen and smooth muscle in the walls of thesevessels.The slices were scanned with a microspectrophotometer and the relative contents of thecomponents mentioned above were represented with the mean absorbance respectively.It was found that no significant difference existed in the contents of the above mentioned com-ponents between the left and right coronary arteries(P】0.05).The internal thoracic artery con-tains relatively higher elastin than the others(P【0.01).The contain a highcollagen/elastin ratio(P【0.01),which makes the coronary arteries be suitable to carry out thespecial functional needs of the heart. 展开更多
关键词 coronary ARTERY internal THORACIC ARTERY great saphenous VEIN vascular smooth muscle elastic tissue BIOMECHANICS aortocoronary BYPASS
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经内窥镜大隐静脉获取术在冠状动脉旁路移植术中应用的学习曲线
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作者 张伟华 张俭 +5 位作者 孙晓柯 罗鸿 马宁 刘东海 张新 乔晨晖 《中山大学学报(医学科学版)》 CAS CSCD 北大核心 2024年第2期319-323,共5页
【目的】探讨内窥镜获取大隐静脉在冠状动脉旁路移植术中的应用并探讨学习曲线,重点关注初学者易发生的问题及对早期临床结果的影响。【方法】回顾性分析2013年7月至2014年4月在郑州大学第一附属医院心外科接受不停跳冠状动脉旁路移植... 【目的】探讨内窥镜获取大隐静脉在冠状动脉旁路移植术中的应用并探讨学习曲线,重点关注初学者易发生的问题及对早期临床结果的影响。【方法】回顾性分析2013年7月至2014年4月在郑州大学第一附属医院心外科接受不停跳冠状动脉旁路移植术并使用内窥镜技术获取大隐静脉的83例患者的临床资料,按照手术时间的先后顺序分为A组(初学组20例)、B组(熟悉组20例)、C组(进步组20例)、D组(成熟组23例),分析各组之间患者围术期及随访结果差异,明确学习曲线周期。【结果】该组患者年龄为(60.22±8.06)岁,体质量为(69.77±11.66)kg,其中合并高血压24例、糖尿病26例、亚急性脑梗14例。A组相对于后三组获取大隐静脉长度与时间比值明显较小(P<0.001),静脉主干损伤数量明显较多(P=0.006),并且随访1年时静脉桥通畅率较低,但差异无统计学意义。【结论】内窥镜获取大隐静脉之前技术操作培训是必要的,能有效规避初学者造成的血管损伤,实际获取的过程中大概需要亲自操作20例,并认真总结技术技巧就可以较为熟练地进行相关操作。 展开更多
关键词 冠状动脉旁路移植术 内窥镜 微创 大隐静脉 学习曲线
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