CONGENITAL CORRECTED TRANSPOSITION OF THE GREAT VESSELS: A STUDY OF 33 CASES

摘要: Thirty-three cases of corrected transposition the great vessels are analyzed: 31 in situs solitus, and two inversus. In 18 these 33 cases, which 64% were males, diagnosis was confirmed by necropsy or operation. There no history congenital heart disease families any patients. The person whose sole anomaly is has hemodynamic basis for symptoms. Symptoms result associated lesions, most common anomalies left atrioventricular valve usually causing incompetence, ventricular septal defects, pulmonary valvular stenosis, advanced disturbances conduction. Physical findings depend upon defects. Noncardiac rare. Anteroposterior thoracic roentgenograms may suggest diagnosis, particularly when a narrow waist present at base heart, accompanied absence pulmonary-artery "knob" presence an enlarged atrium. Electrocardiographic features that should block (particularly 2:1 complete block), abnormal P waves, absent low R voltage aVR, initial Q wave leads 3, aVF V1, lead V6, upright T waves across precordium children, clockwise spatial loop frontal plane. Cardiac catheterization be diagnostic this malformation careful documentation made location valves their relation to semilunar valves, together with position anteroposterior lateral views. Alteration hemodynamics secondary malformations. Inability enter artery during arouse suspicion, particularly, angiocardiography can diagnostic. decision as whether frequently malformations exist isolated entities, they combination transposition, appears main differential problem–together differentiation cyanosis from (that is, uncorrected) transposition. Surgical treatment been difficult because before after operation, residual incompetence deformed present, mirror-image arrangement coronary arteries. cause death cardiac failure, often terminal bout edema. average age series about 14 years, median 4 years. A review literature again emphasizes association some degree evidenced on electrocardiogram. reported lesions defect, stenosis atresia, patent ductus arteriosus, dextrocardia. incidence probably underestimated.