CASE REPORT   

Gazzetta Medica Italiana Archivio per le Scienze Mediche 2017 June;176(6):359-62

DOI: 10.23736/S0393-3660.16.03367-2

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

Left ventricle training before late arterial switch to correct congenital transposition of the great arteries with intact ventricular septum

Juan L. PÉREZ-NAVERO ¹, María A. TEJERO-HERNÁNDEZ ¹, Elena GÓMEZ-GUZMÁN ¹, Carlos MERINO-CEJAS ², María J., de la TORRE-AGUILAR ¹, Francisco J. LLORENTE-CANTARERO ¹ ✉

¹ Pediatric Cardiology and Pediatric Intensive Care Unit, Maimónides Biochemical Research Institute of Córdoba (IMIBIC), Reina Sofía Children’s Hospital, Córdoba, Spain; ² Pediatric Cardiovascular Surgery Unit, Reina Sofía Children’s Hospital, Córdoba, Spain

There is disagreement regarding the best surgical technique to correct congenital transposition of the great arteries with intact ventricular septum (TGA-IVS) in infants older than two months. In patients beyond the neonatal period, left ventricle (LV) is no longer suitable to handle the high pressure systemic circulation after arterial switch operation (ASO). We report a case of successful surgical repair of TGA-IVS in a 10-week-old patient. Interatrial septostomy was performed at 12 hours of life, subsequently pulse oximetry oxyhemoglobin saturation (SpO2) was 80%. LV ejection fraction was 40% with small and hypertrophic LV. In order to avoid heart failure, LV was trained prior to ASO. LV training was performed by pulmonary artery banding together with a systemic-to-pulmonary shunt, who had developed hemodynamic instability postoperatively. Echocardiographic changes in function and mass of LV are discussed. In this case report LV training avoids LV failure after ASO.

KEY WORDS: Transposition of the great vessels - Heart ventricles - Arterial switch operation