D-Transposition of the great arteries
- Etiology: Ventriculo-arterial discordance, systemic pulmonary pathways in parallel, not an obstructive heart lesion but a neonatal ductal dependent lesion
- Imaging: Admixture lesion leads to cyanosis and increased pulmonary blood flow
- Imaging: Aorta in front of pulmonary artery, prominent pulmonary artery = shunt vascularity
- Imaging CXR: Egg on a string heart – heart appears egg shaped due to abnormal convexity of right atrial border and left atrial enlargement while superior mediastinum appears narrow due to stress-induced thymic atrophy and hyperinflated lungs
- DDX:
- Complications:
- Treatment: Temporized via balloon atrial septostomy, corrected by Jatene procedure (arterial switch) which can be complicated by stenoses near coronary ostia
- Clinical:
L-Transposition of the great arteries
- Etiology: Atrio-ventricular discordance
- Imaging: Admixture lesion leads to cyanosis and increased pulmonary blood flow
- Imaging: Aorta in front of pulmonary artery, prominent pulmonary artery = shunt vascularity
- Imaging CXR: Egg on a string heart – heart appears egg shaped due to abnormal convexity of right atrial border and left atrial enlargement while superior mediastinum appears narrow due to stress-induced thymic atrophy and hyperinflated lungs
- DDX:
- Complications:
- Treatment: Corrected by Jatene procedure (arterial switch) which can be complicated by stenoses near coronary ostia
- Clinical:
Radiology Cases of Transposition of the Great Arteries
Radiology Cases of D-Transposition of the Great Arteries
