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Congenitally Corrected Transposition of the Great Arteries

  • Constantine Mavroudis
  • Joseph A. Dearani
Chapter

Abstract

Congenitally corrected transposition of the great arteries (ccTGA) is a complex congenital heart defect that is defined by atrioventricular and ventriculoarterial discordance. Figure 10.1 shows a coronal view of a heart with ccTGA and ventricular septal defect (VSD). The morphologic right atrium (systemic collecting chamber) is connected to the morphologic left ventricle through a mitral valve, which is connected to the pulmonary artery. The morphologic left atrium (pulmonary venous collecting chamber) is connected to the morphologic right ventricle through a tricuspid valve, which is connected to the aorta. This arrangement results in physiologically corrected but not anatomically corrected circulation. Circulatory aberrations are generally owing to associated lesions that include VSDs, pulmonary stenosis (PS) or atresia, and tricuspid valve abnormalities. Congenitally corrected transposition of the great arteries may also occur in association with situs solitus (normal atrial situs) or situs inversus. In addition, the conduction system in patients with ccTGA is notably atypical, and the incidence of spontaneous heart block is high even without surgical correction.

Keywords

Adult congenital heart surgery Atrioventricular discordance ccTGA Double switch operation Mustard-Rastelli operation Surgical treatment Ventriculoarterial discordance 

Abbreviations

Ao

Aorta

AV

Atrioventricular

ccTGA

Congenitally corrected transposition of the great arteries

CS

Coronary sinus

IVC

Inferior vena cava, also known as inferior caval vein

LV

Left ventricle

LVOT

Left ventricular outflow tract

MV

Mitral valve

PA

Pulmonary artery

PS

Pulmonary stenosis

PV

Pulmonary vein

RA

Right atrium

RV

Right ventricle

SVC

Superior vena cava, also known as superior caval vein

TV

Tricuspid valve

VSD

Ventricular septal defect

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Constantine Mavroudis
    • 1
  • Joseph A. Dearani
    • 2
  1. 1.Professor of SurgeryJohns Hopkins University School of Medicine, Johns Hopkins All Children’s HospitalSt. PetersburgUSA
  2. 2.Professor of Surgery, Department of Cardiac SurgeryMayo ClinicRochesterUSA

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