Lately Performed Arterial Switch Operation in a Three Years Old Child Diagnosed of Transposition of Great Arteries | Stephy publishers

 


Journal of Pediatrics and Clinical Neonatology | Stephy Publishers


Abstract
Bacground: Insidans for transposition of great arterieas(TGA) is %0.5-1 of all congential hearth diseases. There is reverse output of aorta and pulmonary arteries in hearth ventricules. Additionally there is ventriculer septal defect(VSD) in %25 of TGA patients. In some infants there can be either left ventriculer outflow tract stenosis. Arterial switch (Jaten) operation is current accepted procedure for TGA treatment.

Case presentation: The Patient with the symptom of severe syanosis from birth have been diagnosed as TGA, VSD and ASD with pediatric cardiology examination in an extarnal hospital. After a withut follow-up period; when 34 months age the patient applicated to our institute hospital by the complains of severe synosis and reduction of effort capacity. According to ecocardiography and angiograghy findings, Arterial switch operation(AS) planned and performed even late age of patient.

Conclusion: Generally; AS in TGA patients is prefered to be done in the first month of life. In literature there is very rare cases presented in early childhood patients. In respect to this knowledge we presented a succesful atrial switch operation in three years old patient.

Keywords
Arterial switch(Jaten) operation, transposition of great arterieas (TGA)

Introduction

In TGA patients circulating blood have to be mixed in hearth or anywhere else to continue of life before total correcting operation. Mixing of blood is critical for life maintenance. VSD, atrial septal defect (ASD) or patent ductus arteriosus(PDA) is very important to let this mixing by natural way in this patients. If this event of mixing is not possible by these natural ways an emergency catheterization or atrial septostomy (AS) is necessary to perform.1 Generally neonatal first 3 weeks is prefered for AS operation. When this duration delayed mostly AS operation is not possible to perform. To perform delayed correction, firstly palyatif cardiac surgical prosedures is needed to do.2 We presented a 3 years of child with diagnosis of TGA accompanying VSD and ASD in which previously pulmonary bunding operation have been performed.

Case Report

The Patient with the symptom of severe syanosis from birth have been diagnosed as TGA, VSD and ASD via pediatric cardiology examination in an extarnal hospital. Medical treatment managed till 8 months age and afterward the patient refered to our institute hospital and palliative surgery have been planned. Pulmonary bunding and surgical operation have been performed and the patient excharged. When 34 months age the patient applicated to our institute hospital by the complains of severe synosis and reduction of effort capacity. An echocardiography and angiography have been performed. Pulmonary gradient was 68 mmHg (Figure 1). Atrioventriculer relation was conformable, hearth blanks were normal and ventriculer contractions were normal.There was no ventriculer wall hypoplasia. The valvuler morphology was normal. In angiography no coranary abnormalitiy have been detected.3 There was no pulmonary hypertension in pulmunary catheterization (Figure 2).


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