Transposition of the Great Arteries

  • Etiology
    — D-TGA – ventriculo-arterial discordance, systemic pulmonary pathways in parallel, non an obstructive heart lesion but a neonatal ductal dependent lesion
    — L-TGA – atrio-ventricular discordance
  • CXR: Egg on a string heart – heart appears egg shaped due to abnormal convexity of right atrial border + left atrial enlargement while superior mediastinum appears narrow due to stress-induced thymic atrophy + hyperinflated lungs
  • Imaging: aorta in front of pulmonary artery, prominent pulmonary artery = shunt vascularity
  • Clinical: temporized via balloon atrial septostomy, corrected by Jatene procedure (arterial switch) which can be complicated by stenoses near coronary ostia

Cases of Transposition of the Great Arteries

CXR of transposition of the great arteries
CXR AP shows increased pulmonary blood flow and an egg on a string-shaped heart.
CXR of transposition of the great arteries / transposition of the great vessels / TGA
CXR AP shows increased pulmonary vascularity and cardiomegaly.