Frequency of the malformation. According to clinical data, frequency of the Total Transposition of the Great Vessels among all the congenital heart malformations ranges from 4,2 to 9,9 %, according to patholo-anatomical data – from 15,7 to 20,8 %. Transposition of the Great Vessels takes second place after Tetralogy of Fallot.
Interaction with other defects. Transposition of the Great Vessels can be observed under different chromosome aberrations and congenital syndromes.
Clinical manifestation of the malformation depends from the peculiarities of the hemodynamics. In transposition of great vessels one of the defects is the opening of the aorta from the right ventricle. The venous blood goes into the general circulation at once - the shunt is from the right to the left. Transposition of the Great Vessels (Arteries) – is a congenital heart malformation of the blue type – «blue abnormality». Oxygenation of the systemic blood may occur by mixing at any or all of three level: a ventricular septal defect, an atrial septal defect, a patent ductus arteriosus.
Early neonatal and postnatal diagnostics. In situations in which the ventricular septum is infact, cyanosis and tachypnea are recognized in the first hours or days of life. Cardiac examination often is subtle. Cardiac examination is remarkable for a systolic ventricular septal defect – murmur.
Chest roentgenograms reveal a globular heart («egg on string» appearance), cardiomegaly.
The electrocardiogram typically shows peaked P waves and either right ventricular or biventricular hypertrophy.
Differential diagnostics should be led with the Corrected transposition of the great vessels with ussing the echocardiography.
Treatment. The early surgical correction is recommended to Patients with a transposition of the great vessels. Palliative and radical operations are worked out. Palliative treatment of these lesion cjnsist balloon atrial septostomy in effort to increase mixing. The infusion of the E1 prostaglandin are prescribed, until the surgical correction is done in newborn with a patent ductus arteriosus.
Prognosis with the Total Transposition of the Great Vessels with the natural course of the malformation is extremely severe. Most children die during the first year of life. The prognosis is determined with the anatomical kind of this malformation and variant of the surgical correction.
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