Cyanogenic congenital heart disease: transposition of the great arteries

Transposition of the great arteries is a cyanogenic congenital heart disease; it sees the aorta and pulmonary artery having an inverted connection

The pulmonary artery arises from the left ventricle and the aorta from the right ventricle, a condition opposite to the normal cardiac anatomy; this inversion will cause the alteration of the normal blood circulation and therefore the blood returning from the lungs will not go into the systemic circulation but will return to the lungs.

In the transposition of the great arteries, the aorta and the pulmonary artery will have an inverted connection

  • Oxygen-poor blood reaching the right ventricle will reach the whole body;
  • the newly oxygenated blood in the lungs that reaches the left ventricle returns to the lungs, creating two separate circuits.

Transposition of the great arteries is usually accompanied by other heart defects

For those with this condition, there is a need to undergo surgery.

In order for the child to survive, it will be necessary to administer drugs that increase blood flow and improve the mixing of oxygenated and oxygen-free blood.

It may be necessary to use procedures to enlarge the connection between the two atria for the blood to mix.

The patient will be followed up by a cardiologist following the procedure.

It is possible to detect this pathology, either at the birth of the child or during the first weeks of life.

Symptoms may appear at birth or some time later, and will be: cyanosis, breathlessness, lack of appetite, poor weight gain.

The diagnosis could also be made in the embryonic phase with ultrasound; for the diagnosis to be accurate, echocardiography, chest X-ray, electrocardiogram and cardiac catheterisation should also be performed.

The origin of transposition of the great arteries is unknown, as are most congenital heart defects; but certain factors related to the mother are associated with a higher rate of occurrence of transposition, including: rubella during pregnancy, poor eating habits, alcoholism, diabetes.

As a congenital heart defect with unknown causes, it is impossible to prevent; however, if detected early, related complications that occur throughout the life of the sufferer can be prevented.

Within the first two weeks of the child’s life, transposition will be surgically resolved by means of the Jatene operation, also known as arterial switch.

During the operation, the arterial position will be restored: the pulmonary artery and the aorta are placed in their normal positions.

And atrial surgery will also be performed by making a tunnel between the two atria that allows the right ventricle to pump blood to the whole body.

It may be inadvisable to practise certain sports.

If the patient undergoes dental procedures, he or she should take antibiotics in order to avoid infection.

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