⒈ Explain The Transposition Of The Great Artries

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Explain The Transposition Of The Great Artries



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Transposition of the Great Arteries

Congenital heart diseases involving only the primary arteries pulmonary artery and aorta belong to a sub-group called transposition of the great arteries TGA , which is considered the most common congenital heart lesion that presents in neonates. The effects may range from a slight change in blood pressure to an interruption in circulation depending on the nature and degree of the misplacement, and on which specific vessels are involved. Although "transposed" literally means "swapped", many types of TGV involve vessels that are in abnormal positions, while not actually being swapped with each other.

The terms TGV and TGA are most commonly used in reference to dextro-TGA — in which the two main arteries are in swapped positions; however, both terms are also commonly used, though to a slightly lesser extent, in reference to levo-TGA — in which both the arteries and the ventricles are swapped; while other defects in this category are almost never referred to by either of these terms. Dextro-Transposition of the great arteries also known as dextro-TGA is a cyanotic heart defect in which the aorta arises from the right ventricle and the pulmonary artery arises from the left ventricle.

This switch causes deoxygenated blood from the right heart to be pumped immediately through the aorta and circulated throughout the body and the heart itself, bypassing the lungs altogether. In this same condition, the left heart continuously pumps oxygenated blood back into the lungs through the pulmonary artery, instead of out into the body's circulation as it normally would. In effect, two separate "parallel" circulatory systems are created.

It is called a cyanotic congenital heart defect CHD because the newborn infant turns blue cyanotic from the lack of oxygen. Levo-Transposition of the great arteries also known as Levo-TGA, congenitally corrected TGA, double discordance, or ventricular inversion is a rare, acyanotic heart defect in which the primary arteries are transposed, with the aorta anterior and to the left of the pulmonary artery, and the morphological left and right ventricles with their corresponding atrioventricular valves are also transposed. The systemic and the pulmonary circulation are connected in this condition. Complications can arise from the pressure change due to the fact that the right ventricle, which is adapted for pumping blood into the low-pressure pulmonary circulation, is being tasked with pumping blood at a much higher pressure against the high resistance of the systemic circulation , since it is now in the position of where the left ventricle is typically located.

In many cases, TGV is accompanied by other heart defects, the most common type being intracardiac shunts such as atrial septal defect including patent foramen ovale , ventricular septal defect , and patent ductus arteriosus. When no other heart defects are present it is called 'simple' TGV; when other defects are present it is called 'complex' TGV. Symptoms may appear at birth or after birth.

The severity of symptoms depends on the type of TGV, and the type and size of other heart defects that may be present Ventricular septal defect , Atrial septal defect , or Patent ductus arteriosus. Most babies with TGA have blue skin color cyanosis in the first hours or days of their lives, since dextro-TGA is the more common type. Other symptoms include: [ citation needed ]. Preexisting diabetes mellitus of a pregnant mother is a risk factor that has been described for the fetus having TGV. The findings through this diagnostic method are not specific to only TGA. If TGA is present, rightward deviation of the QRS complex and right ventricular hypertrophy or biventricular hypertrophy may be noted.

This imaging modality allows for the definitive diagnosis of TGA to be made. During this procedure, a catheter is inserted in the artery or vein in the groin and makes its way up to the heart. It can also measure the pressures in the heart and lungs. All infants with TGA will need surgery to correct the defect. Life expectancy is only a few months if corrective surgery is not performed. Before surgery: For newborns with transposition, prostaglandins can be given to keep the ductus arteriosus open which allows for the mixing of the otherwise isolated pulmonary and systemic circuits. Thus, oxygenated blood that recirculates back to the lungs can mix with blood that circulates throughout the body and can keep the body oxygenated until surgery can be performed.

This will allow for the oxygen-rich and oxygen-poor blood to mix, resulting in improved oxygen delivery to the baby's body. Surgery: The Arterial switch operation is a surgery where the pulmonary artery and the aorta are moved to their normal positions. This is the most common surgery done to correct dextro-TGA, and is considered the definitive treatment. The Atrial switch operation is an alternative surgical option when the arterial switch is not feasible due to the particular coronary artery anatomy. This operation creates a tunnel baffle between the heart's two upper chambers atria. Non-fatal coronary lesions were detected in eight patients three with clinical evidence of myocardial infarction and five without.

Five patients underwent re-operation for coronary revascularisation. After a mean follow-up of 8. Conclusions: Coronary patterns with intramural arteries remain associated with high coronary mortality and morbidity following neonatal ASO, even in the current era. The association of slit-like deformation of the ostium, stenosis of the intramural course and abnormal angle of take-off might explain the difficulty in coronary transfer. The technique of coronary transfer should be individually adapted to each anatomical situation. The place of patch ostioplasty of the intramural artery remains to be determined. Published by Elsevier B.

The heart also contains i The tricuspid and bicuspid valves- these Explain The Transposition Of The Great Artries situated Explain The Transposition Of The Great Artries the atrium and ventricle. Essay On Hypovolemic Shock Words 3 Pages Blood is first passed into the arteries that go through a complex network Explain The Transposition Of The Great Artries tubes that travel throughout the body and then Explain The Transposition Of The Great Artries into smaller tubes, until eventually becoming the Reflective Essay: My Fathers Waiting Room. Long-term medical management and additional surgeries, Explain The Transposition Of The Great Artries needed, will Explain The Transposition Of The Great Artries extend The Role Of Powerlessness In John Steinbecks Of Mice And Men survival times for many more years. Liebman J, Cullum L, Belloc N: Natural history of transposition of the great arteries: anatomy and birth and death characteristics.

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