corrected transposition of great vessels

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  Notes
 
 
Slide 1 : ccTGA Dept of CTS GRH, Madurai
Slide 2 : Discordant atrio –ventricular and ventriculo – arterial connection Physiologically normal Anatomical derangement DEFINITION
Slide 3 : VSD LVOTO TV dysplasia Anterior AV node Mitral – pulmonary fibrous continuity Aorta anterior and left of PA ASSOCIATED DEFECTS
Slide 4 : 50 – 80% Perimembranous PV overrides VSD Bundle related to superior & anterior border VSD
Slide 5 : PV sandwitched between MV & TV Valvar – dysplastic bulky leaflets Subvalvar – membrane Accessory valve tissue Dynamic – bulging IVS LVOTO
Slide 6 : Dysplastic Thickened chordae Regurgitant Ebstein anomaly LEFT AV (TV) VALVE
Slide 7 : Anterior AV node Atrial septum adjacent to AV valve Bundle Inferior to PV Superior anterior border of VSD LV side of septum ( geographic right) CONDUCTION SYSTEM
Slide 8 : Reversed manner RCA – LAD & LCx LCA – RV & PDA Anterior sinus – non coronary CORONARY ARTERY
Slide 9 : Increased pulmonary blood flow – VSD Conduction block Cyanosis – LVOTO TR Systemic ventricular dysfunction SYMPTOMS
Slide 10 :
Slide 11 : UNSEPTATABLE Straddling of AV valve Hypoplasia of one ventricle Multiple VSD FONTAN strategy MANAGEMENT
Slide 12 : CLASSIC REPAIR INDICATION Competent both AV valve Balanced ventricle Excellent RV function DISADVANTAGE TR RV failure
Slide 13 : CLASSIC REPAIR
Slide 14 : ANATOMIC REPAIR INDICATION Disparity of ventricle size Poor RV function TR Systemic LV pressure ADVANTAGES Long term outcome – better RV function improves
Slide 15 : No obstruction Balanced ventricle size Septatable heart LV pressure 75% of RV Translocatable coronary artery SENNING + SWITCH
Slide 16 : SENNING
Slide 17 : SYSTEMIC VENOUS BAFFLE
Slide 18 : SEPTUM PRIMUM
Slide 19 : SYSTEMIC VENOUS BAFFLE
Slide 20 : PULMONARY VENOUS ATRIUM
Slide 21 : ARTERIAL SWITCH
Slide 22 : ARTERIAL SWITCH
Slide 23 : DOUBLE SWITCH
Slide 24 : VSD + LVOTO Intra ventricular tunnel to connect LV – Aorta RV – PA conduit SENNING + RASTELLI
Slide 25 : RASTELLI
Slide 26 : SENNING + REV
Slide 27 : TV replacement Double switch After LV retraining Transplant FAILED CLASSIC
Slide 28 : THANK YOU THANK YOU

 


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