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Echocardiography of transposition of the great arteries*

Published online by Cambridge University Press:  18 January 2013

William T. Mahle*
Affiliation:
Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, United States of America
Javier H. Gonzalez
Affiliation:
All Children's Hospital, Saint Petersburg, Florida, United States of America
Joseph Kreeger
Affiliation:
Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, United States of America
Gerald Marx
Affiliation:
Boston Children's Hospital, Boston, Massachusetts, United States of America
Gul Duldani
Affiliation:
All Children's Hospital, Saint Petersburg, Florida, United States of America
Norman H. Silverman
Affiliation:
Stanford University School of Medicine and Lucille Packard Children's Hospital, Stanford, California, United States of America
*
Correspondence to: Dr W. T. Mahle, MD, Children's Healthcare of Atlanta, Emory University School of Medicine and Lucille Packard Children's Hospital, 1405 Clifton Road, NE, Atlanta, GA 30322-1062, United States of America. Tel: +1 404 315 2672; Fax: +1 404 325 6021; E-mail: [email protected]

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.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2012

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Footnotes

*

Presented at: 12th Annual International Symposium on Congenital Heart Disease, February 17–21, 2012, All Children's Hospital, Saint Petersburg, Florida, United States of America.

References

1. Van, PR. Transposition of the great arteries. II. Transposition clarified. Am J Cardiol 1971; 28: 739741.Google Scholar
2. Crupi, G, Anderson, RH, Ho, SY, Lincoln, C, Buckley, MJ. Complete transposition of the great arteries with intact ventricular septum and left ventricular outflow tract obstruction. Surgical management and anatomic considerations. J Thorac Cardiovasc Surg 1979; 78: 730738.Google Scholar
3. Nikaidoh, H. Aortic translocation and biventricular outflow tract reconstruction. A new surgical repair for transposition of the great arteries associated with ventricular septal defect and pulmonary stenosis. J Thorac Cardiovasc Surg 1984; 88: 365372.Google Scholar
4. Sohn, YS, Brizard, CP, Cochrane, AD, Wilkinson, JL, Mas, C, Karl, TR. Arterial switch in hearts with left ventricular outflow and pulmonary valve abnormalities. Ann Thorac Surg 1998; 66: 842848.CrossRefGoogle ScholarPubMed
5. Serraf, A, Lacour-Gayet, F, Bruniaux, J, et al. Anatomic correction of transposition of the great arteries in neonates. J Am Coll Cardiol 1993; 22: 193200.CrossRefGoogle ScholarPubMed
6. Beitzke, A, Stein, JI, Suppan, C. Balloon atrial septostomy under two-dimensional echocardiographic control. Int J Cardiol 1991; 30: 3342.Google Scholar
7. Gremmels, DB, Tacy, TA, Brook, MM, Silverman, NH. Accuracy of coronary artery anatomy using two-dimensional echocardiography in d-transposition of great arteries using a two-reviewer method. J Am Soc Echocardiogr 2004; 17: 454460.Google Scholar
8. Pasquini, L, Sanders, SP, Parness, IA, et al. Coronary echocardiography in 406 patients with d-loop transposition of the great arteries. J Am Coll Cardiol 1994; 24: 763768.CrossRefGoogle ScholarPubMed
9. Pasquini, L, Parness, IA, Colan, SD, Wernovsky, G, Mayer, JE, Sanders, SP. Diagnosis of intramural coronary artery in transposition of the great arteries using two-dimensional echocardiography. Circulation 1993; 88: 11361141.CrossRefGoogle ScholarPubMed
10. Lacour-Gayet, F, Piot, D, Zoghbi, J, et al. Surgical management and indication of left ventricular retraining in arterial switch for transposition of the great arteries with intact ventricular septum. Eur J Cardiothorac Surg 2001; 20: 824829.Google Scholar
11. Rychik, J, Norwood, WI, Chin, AJ. Doppler color flow mapping assessment of residual shunt after closure of large ventricular septal defects. Circulation 1991; 84 (5 Suppl): III153III161.Google Scholar
12. Taylor, AM, Dymarkowski, S, Hamaekers, P, et al. MR coronary angiography and late-enhancement myocardial MR in children who underwent arterial switch surgery for transposition of great arteries. Radiology 2005; 234: 542547.CrossRefGoogle ScholarPubMed
13. Hui, L, Chau, AK, Leung, MP, Chiu, CS, Cheung, YF. Assessment of left ventricular function long term after arterial switch operation for transposition of the great arteries by dobutamine stress echocardiography. Heart 2005; 91: 6872.CrossRefGoogle ScholarPubMed
14. Hourihan, M, Colan, SD, Wernovsky, G, Maheswari, U, Mayer, JE Jr, Sanders, SP. Growth of the aortic anastomosis, annulus, and root after the arterial switch procedure performed in infancy. Circulation 1993; 88: 615620.CrossRefGoogle ScholarPubMed
15. Lopez, L, Colan, SD, Frommelt, PC, et al. Recommendations for quantification methods during the performance of a pediatric echocardiogram: a report from the pediatric measurements writing group of the American Society of Echocardiography Pediatric and Congenital Heart Disease Council. J Am Soc Echocardiogr 2010; 23: 465495.CrossRefGoogle ScholarPubMed