Advertisement

Transposition of the Great Arteries

Congenital Heart Diseases in Adults: Imaging and Diagnosis
  • Matthias Grothoff
  • Matthias GutberletEmail author
Chapter
Part of the Medical Radiology book series (MEDRAD)

Abstract

Transposition of the great arteries (TGA) is the second most common cyanotic congenital heart disease. It is characterized by a ventriculo-arterial discordance with the aorta arising from the right ventricle and the pulmonary artery arising from the left ventricle. For initial diagnosis echocardiography is used. The postoperative imaging protocol strongly depends on the type of surgical repair, of which each has its specific long-term complications. CMR provides the most detailed information in morphology, function, and tissue characterization and is routinely used in follow-up examinations. Modern CMR imaging sequences like 4D PC flow measurement and T1 mapping are under evaluation.

References

  1. Babu-Narayan SV, Goktekin O, Moon JC et al (2005) Late gadolinium enhancement cardiovascular magnetic resonance of the systemic right ventricle in adults with previous atrial redirection surgery for transposition of the great arteries. Circulation 111:2091–2098CrossRefGoogle Scholar
  2. Duncan BW, Mee RB, Mesia CI et al (2003) Results of the double switch operation for congenitally corrected transposition of the great arteries. Eur J Cardiothorac Surg 24:11–19CrossRefGoogle Scholar
  3. Ferencz C, Brenner JI, Loffredo C, Kappetein AP, Wilson PD (1995) Transposition of the great arteries: etiologic distinctions of outflow tract defects in a case control study of risk factors. In: Clark EB, Markwald RR, Takao A (eds) Developmental mechanism of heart disease. Futura, Armonk, pp 639–653Google Scholar
  4. Filippov AA, del Nido PJ, Vasilyev NV (2016) Management of systemic right ventricular failure in patients with congenitally corrected transposition of the great arteries. Circulation 134:1293–1302CrossRefGoogle Scholar
  5. Fricke TA, d’Udekem Y, Richardson M et al (2012) Outcomes of the arterial switch operation for transposition of the great arteries: 25 years of experience. Ann Thorac Surg 94(1):139–145CrossRefGoogle Scholar
  6. Goor DA, Edwards JP (1973) The spectrum of transposition of the great arteries: with special reference to developmental anatomy of the conus. Circulation 48:406–415CrossRefGoogle Scholar
  7. Greil G, Tandon A, Vieira MS et al (2017) 3D whole heart imaging for congenital heart disease. Front Pediatr 5:36CrossRefGoogle Scholar
  8. Grothoff M, Hoffmann J, Abdul-Khaliq H et al (2012) Right ventricular hypertrophy after atrial switch operation: normal adaptation process or risk factor? A cardiac magnetic resonance study. Clin Res Cardiol 101:963–971CrossRefGoogle Scholar
  9. Jatene A, Fontes V, Paulista P et al (1976) Anatomic correction of transposition of the great vessels. J Thorac Cardiovasc Surg 72:364–370PubMedGoogle Scholar
  10. Jouannic JM, Gavard L, Fermont L et al (2004) Sensitivity and specificity of prenatal features of physiological shunts to predict neonatal clinical status in transposition of the great arteries. Circulation 110:1743–1746CrossRefGoogle Scholar
  11. Kilner PJ, Geva T, Kaemmerer H et al (2010) Recommendations for cardiovascular magnetic resonance in adults with congenital heart disease from the respective working groups of the European Society of Cardiology. Eur Heart J 31:794–805CrossRefGoogle Scholar
  12. de la Cruz MV, Arteaga M, Espino-Vela J, Quero-Jimenez M, Anderson RH, Diaz GF (1981) Complete transposition of the great arteries: types and morphogenesis of ventriculoarterial discordance. Am Heart J 102:271–281CrossRefGoogle Scholar
  13. Loffredo CA, Silbergeld EK, Ferrencz C, Zhang J (2001) Association of transposition of the great arteries in infants with maternal exposures to herbicides and rodenticides. Am J Epidemiol 153:529–536CrossRefGoogle Scholar
  14. Lu JC, Dorfman AL, Attili AK et al (2012) Evaluation with cardiovascular MR imaging of baffles and conduits used in palliation or repair of congenital heart disease. Radiographics 32:E107–E127CrossRefGoogle Scholar
  15. Meinel FG, Henzler T, Schoepf UJ, Park PW, Huda W, Spearman JV et al (2015) ECG-synchronized CT angiography in 324 consecutive pediatric patients: spectrum of indications and trends in radiation dose. Pediatr Cardiol 36:569–578CrossRefGoogle Scholar
  16. Murtuza B, Barron DJ, Stumper O, Stickley J, Eaton D, Jones TJ, Brawn WJ (2011) Anatomic repair for congenitally corrected transposition of the great arteries: a single-institution 19-year experience. J Thorac Cardiovasc Surg 142:1348–1357CrossRefGoogle Scholar
  17. Pexieder T, Blanc O, Pelouch V, Ostadalova I, Milerova M, Ostadal B (1995) Late fetal development of retinoic acid-induced transposition of great arteries: morphology, physiology and biochemistry. In: Clark EB, Markwald RR, Takao A (eds) Developmental mechanism of heart disease. Futura, Armonk, pp 297–307Google Scholar
  18. Plymen CM, Sado DM, Taylor AM et al (2013) Diffuse myocardial fibrosis in the systemic right ventricle of patients late after Mustard or Senning surgery: an equilibrium contrast cardiovascular magnetic resonance study. Eur Heart J Cardiovasc Imaging 14:963–968CrossRefGoogle Scholar
  19. Preim U, Hoffmann J, Lehmkuhl L et al (2013) Systemic right ventricles rarely show myocardial scars in cardiac magnetic resonance delayed-enhancement imaging. Clin Res Cardiol 102(5):337–344CrossRefGoogle Scholar
  20. Samanek M (2000) Congenital heart malformations: prevalence, severity, survival and quality of life. Cardiol Young 10:179–185CrossRefGoogle Scholar
  21. Szymczyk K, Moll M, Sobczak-Budlewska K et al (2018) Usefulness of routine coronary CT angiography in patients with transposition of the great arteries after an arterial switch operation. Pediatr Cardiol 39:335–346CrossRefGoogle Scholar
  22. Taylor AM, Dymarkowski S, Hamaekers P et al (2005) MR coronary angiography and late-enhancement myocardial MR in children who underwent arterial switch surgery for transposition of great arteries. Radiology 234:542–547CrossRefGoogle Scholar
  23. Unolt M, Putotto C, Silvestri LM et al (2013) Transposition of the great arteries: new insights into the pathogenesis. Front Paediatr 1:11CrossRefGoogle Scholar
  24. Warnes CA (2006) Transposition of the great arteries. Circulation 114:2699–2709CrossRefGoogle Scholar
  25. Williams WG, McCrindle BW, Ashburn DA, Jonas RA, Mavroudis C, Blackstone EH (2003) Outcomes of 829 neonates with complete transposition of the great arteries 12-17 years after repair. Eur J Cardiothorac Surg 24:1–9CrossRefGoogle Scholar

Further Reading

  1. Gutberlet M, Boeckel T, Hosten N, Vogel M, Kühne T, Oellinger H, Ehrenstein T, Venz S, Hetzer R, Bein G, Felix R (2000) Arterial switch procedure for D-transposition of the great arteries: quantitative midterm evaluation of hemodynamic changes with cine MR imaging and phase-shift velocity mapping-initial experience. Radiology 214(2):467–475CrossRefGoogle Scholar
  2. Grothoff M, Fleischer A, Abdul-Khaliq H, Hoffmann J, Lehmkuhl L, Luecke C, Gutberlet M (2013) The systemic right ventricle in congenitally corrected transposition of the great arteries is different from the right ventricle in dextro-transposition after atrial switch: a cardiac magnetic resonance study. Cardiol Young 23(2):239–247.  https://doi.org/10.1017/S1047951112000790 Epub 2012 Jun 14CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG  2019

Authors and Affiliations

  1. 1.Department of Diagnostic and Interventional RadiologyLeipzig Heart CenterLeipzigGermany

Personalised recommendations