Skip to main content
SpringerLink
Log in

Dextro-Transposition of the Great Arteries

  • Chapter
  • First Online:
Pediatric Cardiac CT in Congenital Heart Disease

  • 743 Accesses

Abstract

Dextro-transposition of the great arteries (D-TGA) is the second commonest cyanotic heart defect, accounting for 5% of all congenital heart defects. The diagnosis of D-TGA is generally made by two-dimensional echocardiography. However, given the shortcomings in transthoracic echocardiography to delineate the extent of extracardiac vascular structures and coronary arteries in young infants, cardiac CT is increasingly used both in preoperative and in postoperative evaluation of D-TGA. The common indications for cardiac CT in D-TGA patients include evaluation of coronary arteries, aortic arch, neoaortic root, and pulmonary arteries after arterial switch operation with LeCompte maneuver. The preferred cardiac CT technique is prospective gated cardiac CT using modern dual-source multidetector CT scanners. After arterial switch operation, biventricular contrast injection or triphasic contrast injection technique is used to delineate both right-sided and left-sided structures (pulmonary arteries, coronary arteries, and aortic root).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Jatene AD, Fontes VF, Paulista PP, et al. Anatomic correction of transposition of the great vessels. J Thorac Cardiovasc Surg. 1976;72:364.

    Article  CAS  Google Scholar 

  2. Lecompte Y, Zannini L, Hazan E, et al. Anatomic correction of transposition of the great arteries. J Thorac Cardiovasc Surg. 1981;82:629.

    Article  CAS  Google Scholar 

  3. Szmczyk K, et al. Usefulness of routine CT angiography in patients with transposition of the great arteries after an arterial switch operation. Pediatr Cardiol. 2018;39(2):335–46.

    Article  Google Scholar 

  4. Ou P, Mousseaux E, Azarine A, et al. Detection of coronary complications after the arterial switch operation for transposition of the great arteries: first experience with multislice computed tomography in children. J Thorac Cardiovasc Surg. 2006;131:639.

    Article  Google Scholar 

  5. Dodge-Khatami J, Adebo DA. Evaluation of complex congenital heart disease in infants using low dose cardiac computed tomography. Int J Cardiovasc Imaging. 2021; https://doi.org/10.1007/s10554-020-02118-7.

  6. Goo HW, Park IS, Ko JK, Kim YH, Seo DM, Park JJ. Computed tomography for the diagnosis of congenital heart disease in pediatric and adult patients. Int J Cardiovasc Imaging. 2005;21:347–65. https://doi.org/10.1007/s10554-004-4015-0.

    Article  PubMed  Google Scholar 

  7. Leschka S, Oechslin E, Husmann L, et al. Pre- and postoperative evaluation of congenital heart disease in children and adults with 64-section CT. Radiographics. 2007;27:829–46. https://doi.org/10.1148/rg.273065713.

    Article  PubMed  Google Scholar 

  8. Han BK, Lindberg J, Grant K, Schwartz RS, Lesser JR. Accuracy and safety of high pitch computed tomography imaging in young children with complex congenital heart disease. Am J Cardiol. 2011;107:1541–6. https://doi.org/10.1016/j.amjcard.2011.01.065.

    Article  PubMed  Google Scholar 

  9. Schicchi N, Fogante M, Pirani E, et al. Third-generation dual-source dual-energy CT in pediatric congenital heart disease patients: state-of-the-art. Radiol Med. 2019;124:1238–52. https://doi.org/10.1007/s11547-019-01097-7.

    Article  PubMed  Google Scholar 

  10. Paul JF, Rohnean A, Sigal-Cinqualbre A. Multidetector CT for congenital heart patients: what a pediatric radiologist should know. Pediatr Radiol. 2010;40:869–75. https://doi.org/10.1007/s00247-010-1614-x.

    Article  PubMed  Google Scholar 

  11. Hu XH, Huang GY, Pa M, et al. Multidetector CT angiography and 3D reconstruction in young children with coarctation of the aorta. Pediatr Cardiol. 2008;29:726–31. https://doi.org/10.1007/s00246-008-9226-z.

    Article  PubMed  Google Scholar 

  12. Cheng Z, Wang X, Duan Y, et al. Low-dose prospective ECG-triggering dual-source CT angiography in infants and children with complex congenital heart disease: first experience. Eur Radiol. 2010;20:2503–11. https://doi.org/10.1007/s00330-010-1822-7.

    Article  PubMed  Google Scholar 

  13. Booij R, Dijkshoorn ML, van Straten M, et al. Cardiovascular imaging in pediatric patients using dual source CT. J Cardiovasc Comput Tomogr. 2016;10(1):13–21. https://doi.org/10.1016/j.jcct.2015.10.003.

    Article  PubMed  Google Scholar 

  14. Yu FF, Lu B, Gao Y, et al. Congenital anomalies of coronary arteries in complex congenital heart disease: diagnosis and analysis with dual-source CT. J Cardiovasc Comput Tomogr. 2013;7:383–90.

    Article  Google Scholar 

  15. Ou P, Celermajer DS, Marini D, et al. Safety and accuracy of 64-slice computed tomography coronary angiography in children after the arterial switch operation for transposition of the great arteries. JACC Cardiovasc Imaging. 2008;1:331–9.

    Article  Google Scholar 

  16. Blyth M, Howe D, Gnanapragasam J, Wellesley D. The hidden mortality of transposition of the great arteries and survival advantage provided by prenatal diagnosis. BJOG. 2008;115:1096.

    Article  CAS  Google Scholar 

  17. Calderon J, Angeard N, Moutier S, et al. Impact of prenatal diagnosis on neurocognitive outcomes in children with transposition of the great arteries. J Pediatr. 2012;161:94.

    Article  Google Scholar 

  18. Freed MD, Heymann MA, Lewis AB, et al. Prostaglandin E1 infants with ductus arteriosus-dependent congenital heart disease. Circulation. 1981;64:899.

    Article  CAS  Google Scholar 

  19. Brown JW, Ruzmetov M, Huynh D, et al. Rastelli operation for transposition of the great arteries with ventricular septal defect and pulmonary stenosis. Ann Thorac Surg. 2011;91:188.

    Article  Google Scholar 

  20. Emani SM, Beroukhim R, Zurakowski D, et al. Outcomes after anatomic repair for d-transposition of the great arteries with left ventricular outflow tract obstruction. Circulation. 2009;120:S53.

    Article  Google Scholar 

  21. Honjo O, Kotani Y, Bharucha T, et al. Anatomical factors determining surgical decision-making in patients with transposition of the great arteries with left ventricular outflow tract obstruction. Eur J Cardiothorac Surg. 2013;44:1085.

    Article  Google Scholar 

  22. Toyoda Y, Hiramatsu T, Nagashima M, et al. Long-term effect of enlargement of a ventricular septal defect in the Rastelli procedure. Semin Thorac Cardiovasc Surg. 2017;29:215.

    Article  Google Scholar 

  23. Navabi MA, Shabanian R, Kiani A, Rahimzadeh M. The effect of ventricular septal defect enlargement on the outcome of Rastelli or Rastelli-type repair. J Thorac Cardiovasc Surg. 2009;138:390.

    Article  Google Scholar 

  24. Hörer J, Schreiber C, Dworak E, et al. Long-term results after the Rastelli repair for transposition of the great arteries. Ann Thorac Surg. 2007;83:2169.

    Article  Google Scholar 

  25. Hazekamp MG, Gomez AA, Koolbergen DR, et al. Surgery for transposition of the great arteries, ventricular septal defect and left ventricular outflow tract obstruction: European Congenital Heart Surgeons Association multicentre study. Eur J Cardiothorac Surg. 2010;38:699.

    Article  Google Scholar 

  26. Fricke TA, Bulstra AE, Loyer BR, et al. Outcomes of the arterial switch operation in children less than 2.5 kilograms. Ann Thorac Surg. 2017;103:840.

    Article  Google Scholar 

  27. Khairy P, Clair M, Fernandes SM, et al. Cardiovascular outcomes after the arterial switch operation for D-transposition of the great arteries. Circulation. 2013;127:331.

    Article  Google Scholar 

  28. Legendre A, Losay J, Touchot-Koné A, et al. Coronary events after arterial switch operation for transposition of the great arteries. Circulation. 2003;108(Suppl 1):II186.

    PubMed  Google Scholar 

  29. Lo Rito M, Fittipaldi M, Haththotuwa R, et al. Long-term fate of the aortic valve after an arterial switch operation. J Thorac Cardiovasc Surg. 2015;149:1089.

    Article  Google Scholar 

  30. Losay J, Touchot A, Capderou A, et al. Aortic valve regurgitation after arterial switch operation for transposition of the great arteries: incidence, risk factors, and outcome. J Am Coll Cardiol. 2006;47:2057.

    Article  Google Scholar 

  31. Losay J, Touchot A, Serraf A, et al. Late outcome after arterial switch operation for transposition of the great arteries. Circulation. 2001;104(12 Suppl 1):I121–6.

    Article  CAS  Google Scholar 

  32. Manso PH, Amaral FT, Júnior TJ, et al. Outcomes of patients after arterial switch operation: 18 years of experience in a single medium-volume center. Pediatr Cardiol. 2015;36:1657.

    Article  Google Scholar 

  33. Nogi S, McCrindle BW, Boutin C, et al. Fate of the neopulmonary valve after the arterial switch operation in neonates. J Thorac Cardiovasc Surg. 1998;115:557.

    Article  CAS  Google Scholar 

  34. Pasquali SK, Hasselblad V, Li JS, et al. Coronary artery pattern and outcome of arterial switch operation for transposition of the great arteries: a meta-analysis. Circulation. 2002;106:2575.

    Article  Google Scholar 

  35. Raisky O, Bergoend E, Agnoletti G, et al. Late coronary artery lesions after neonatal arterial switch operation: results of surgical coronary revascularization. Eur J Cardiothorac Surg. 2007;31:894.

    Article  Google Scholar 

  36. Schwartz ML, Gauvreau K, del Nido P, et al. Long-term predictors of aortic root dilation and aortic regurgitation after arterial switch operation. Circulation. 2004;110:II128.

    Article  Google Scholar 

  37. Vejlstrup N, Sørensen K, Mattsson E, et al. Long-term outcome of mustard/senning correction for transposition of the great arteries in Sweden and Denmark. Circulation. 2015;132:633.

    Article  Google Scholar 

  38. Buch J, Wennevold A, Jacobsen JR, et al. Long-term follow-up of right ventricular function after mustard operation for transposition of the great arteries. Scand J Thorac Cardiovasc Surg. 1988;22:197.

    Article  CAS  Google Scholar 

  39. Cuypers JA, Eindhoven JA, Slager MA, et al. The natural and unnatural history of the mustard procedure: long-term outcome up to 40 years. Eur Heart J. 2014;35:1666.

    Article  Google Scholar 

  40. Derrick GP, Josen M, Vogel M, et al. Abnormalities of right ventricular long axis function after atrial repair of transposition of the great arteries. Heart. 2001;86:203.

    Article  CAS  Google Scholar 

  41. Gatzoulis MA, Walters J, McLaughlin PR, et al. Late arrhythmia in adults with the mustard procedure for transposition of great arteries: a surrogate marker for right ventricular dysfunction? Heart. 2000;84:409.

    Article  CAS  Google Scholar 

  42. Gelatt M, Hamilton RM, McCrindle BW, et al. Arrhythmia and mortality after the mustard procedure: a 30-year single-center experience. J Am Coll Cardiol. 1997;29:194.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Children’s Heart Institute, Division of Pediatric Cardiology, Children’s Memorial Hermann Hospital, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA

    Laura Schoeneberg

  2. Children’s Heart Institute, Division of Pediatric Cardiology, Non-Invasive Cardiac Imaging, Children’s Memorial Hermann Hospital, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA

    Dilachew A. Adebo

Authors
  1. Laura Schoeneberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Dilachew A. Adebo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Dilachew A. Adebo .

Editor information

Editors and Affiliations

  1. Division of Pediatric Cardiology, The University of Texas Health Science Center, Houston, TX, USA

    Dilachew A. Adebo

Rights and permissions

Reprints and permissions

Copyright information

© 2021 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Schoeneberg, L., Adebo, D.A. (2021). Dextro-Transposition of the Great Arteries . In: Adebo, D.A. (eds) Pediatric Cardiac CT in Congenital Heart Disease. Springer, Cham. https://doi.org/10.1007/978-3-030-74822-7_18

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-74822-7_18

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-74821-0

  • Online ISBN: 978-3-030-74822-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation