Echocardiography of transposition of the great arteries

Abstract

The successful diagnosis, surgical planning, and long-term care of children with transposition of the great arteries require high-quality cardiac imaging with echocardiography. Echocardiography must identify the relevant anatomic variants of transposition of the great arteries, such as of ventricular septal defects and aortic arch anomalies. Methodical and detailed imaging of the coronary arteries is particularly important, as translocation of the coronary arteries is a critical component of the arterial switch procedure. Familiarity with the potential coronary artery variants and the ideal imaging planes is essential for an echocardiographer. Knowledge of both the early and late complications following the arterial switch procedure is essential to optimise post-operative echocardiography. These complications can include residual lesions leading to haemodynamic compromise or progressive late phenomena, such as aortic root dilatation and aortic insufficiency. Echocardiography will continue to be the cornerstone to the lifelong management of transposition of the great arteries, and improvements in technology and increased familiarity with modalities such as stress echocardiography will enhance the role of advanced imaging even further.

Evaluation of the Adequacy of Blood Mixing by Echocardiographic Parameters in Neonates with the Transposition of Great Arteries

“…PGE1 and/ or BAS may be required for this purpose. The most critical passage in considering the blood mixing is through interatrial communication (5,6,7,8). In our study, 22% (n=4) of all patients had antenatal diagnoses, and 33% (n=6) required BAS.…”

“…A profound cyanosis is a sign of poor mixing. Therefore, blood oxygen saturation is a helpful parameter for showing the septostomy requirement in these patients (3,4,5,6).…”

“…It provides data about blood mixing in different levels of the heart and vessels, especially in patients with TGA. Interatrial communication plays a key role in this regard (6,7).…”

Echocardiographic and Surgical Correlation of Coronary Artery Patterns in Transposition of the Great Arteries

“…Currently, the ASO is the standard of care for the surgical correction of TGA. Echocardiography is an accurate and efficient modality for evaluation of coronary patterns in TGA . However, there remains a significant level of inaccuracy when attempting to delineate the coronary pattern .…”

“…Echocardiography is the primary modality in the delineation of the coronary anatomy in TGA . Reports of its ability to accurately identify the CA pattern vary widely, with correct diagnosis ranging from 68% to 95% .…”