Transposition of the great vessels follow up

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Overview

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Dextro-transposition of the great arteries
L-transposition of the great arteries

Pathophysiology

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Differentiating Transposition of the great vessels from other Diseases

Epidemiology and Demographics

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Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Cafer Zorkun, M.D., Ph.D. [3]; Keri Shafer, M.D. [4]; Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [5]

Follow-up

The infant will continue to see a cardiologist on a regular basis. Although these appointments are required less frequently as time goes on, they will continue throughout the lifetime of the individual, and may increase in the event of complications or as the individual approaches middle age.

The cardiology exam may include an echocardiogram, EKG, and/or cardiac stress test in addition to consultation.

Additionally, some individuals may require ongoing medication therapy at home, which may include diuretics (such as lasix or spironolactone), analgesics (such as tylenol), cardiac glycosides (such as digoxin), anticoagulants (such as heparin or aspirin), or other medications. If the individual has undergone stenting, an anticoagulant will be a necessity to prevent build-up around the stent(s), as the body will perceive the foreign body as a wound and attempt to heal it.

Some patients who have had an Atrial Switch such as the Mustard or Senning procedure, may have issues with SA and VA nodal transmissions. Typical symptoms indclude palpitations and problems with low heart rates. This is commonly solved with a Pacemaker unit, providing scar tissue from the original operation does not block its functionality.

More recently, ACE inhibitors have been prescribed to patients in the hope of relieving stress on the heart.

ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease (DO NOT EDIT)[1][2]

Evaluation and Follow-Up of Patients With Congenitally Corrected Transposition of the Great Arteries (DO NOT EDIT)[1][2]

Class I
"1. All patients with CCTGA should have a regular follow-up with a cardiologist who has expertise in ACHD. (Level of Evidence: C)"
"2. Echocardiography-Doppler study and/or MRI should be performed yearly or at least every other year by staff trained in imaging complex CHD. (Level of Evidence: C)"
"3. The following diagnostic evaluations are recommended for patients with CCTGA:
a. ECG. (Level of Evidence: C)
b. Chest x-ray. (Level of Evidence: C)
c. Echocardiography-Doppler study. (Level of Evidence: C)
d. MRI. (Level of Evidence: C)
e. Exercise testing. (Level of Evidence: C)"

References

  1. 1.0 1.1 Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA; et al. (2008). "ACC/AHA 2008 Guidelines for the Management of Adults with Congenital Heart Disease: Executive Summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines for the management of adults with congenital heart disease)". Circulation. 118 (23): 2395–451. doi:10.1161/CIRCULATIONAHA.108.190811. PMID 18997168.
  2. 2.0 2.1 Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA; et al. (2008). "ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". J Am Coll Cardiol. 52 (23): e1–121. doi:10.1016/j.jacc.2008.10.001. PMID 19038677.



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