Pustaka Ilmiah Universitas Padjadjaran

Abstrak

Evaluation of common associated cardiac lesions in transposition of the greatarteries by echocardiography

<p>In D-TGA the aorta arises anteriorly from the right ventricle (RV) carrying desaturated blood to the body, and the pulmonary artery (PA) arises posteriorly from the left ventricle (LV) carrying oxygenated blood back to the lungs. Unlike the situation in a normal heart, there is a fibrous continuity between the pulmonary and mitral valves and subaortic conus is present. (In normal hearts there are aortic-mitral fibrous continuity and subpulmonary conus and the aorta arises from the LV and lies posterior to and right of the pulmonary valve.) The result of D-TGA is complete separation of the pulmonary and systemic circulations. Defects that permit mixing of the two circulations (e.g., atrial septal defect [ASD], ventricular septal defect [VSD], and patent ductus arteriosus [PDA]) are necessary for survival.  About half of these infants do not have associated defects other than a patent foramen ovale (PFO) or a small PDA (i.e., simple TGA).  In about 5% of the patients, left ventricular outflow tract (LVOT) obstruction (or subpulmonary stenosis) occurs.  VSD is present in 30% to 40% of patients with D-TGA and may be located anywhere in the ventricular septum. A combination of VSD and significant LVOT obstruction (or pulmonary stenosis) occurs in about 10% of all patients with D-TGA. Infants with TGA and VSD more commonly have associated defects than those without associated VSD. Such associated defects include COA, interrupted aortic arch, pulmonary atresia, and an overriding or straddling of the atrioventricular (AV) valve.  </p>