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Radiology
Complete Transposition of Great Arteries
Built from Obstetric Imaging
What’s inside
6 sections · 67 slides
Overview
- What you will learn here
The defect itself
Two great arteries plugged into the wrong ventricles
- The heart is built right, but plumbed wrong
- Two words that decide everything
- The normal heart beside a transposed heart
- The formal definition
- Why it counts as a conotruncal anomaly
- 1 in 1000-3000
- Often missed before birth - but less often now
- What causes it
- The genetic picture so far
- Where development goes off track
- What stays perfectly normal
- Defects that often travel with it
- How often each one appears
- One defect or several
- Simple and complex, in plain terms
Two circuits that never meet
Why birth turns a tolerated defect into an emergency
- Normally the two circuits run in series
- From swapped pipes to a blue baby
- Why the fetus is comfortable
- Why the newborn is not
- What decides how sick the baby is
- Mixing is the whole story
Finding it on the scan
The sweep from four chambers up to the trachea
- The one finding that matters
- The sweep that finds it
- How to sweep, step by step
- A four-chamber view that looks reassuring
- Why a normal four-chamber view is a trap
- The vessel leaving the left ventricle takes a wrong road
- Anomalous outflow path from the left ventricle
- Where a vessel first branches gives it away
- Pulmonary artery rising from the left ventricle
- Early branching shown by colour Doppler
- Early split against late split
- Colour Doppler makes the split obvious
- Two arteries running side by side
- Crossover, and what replaces it
- Only two vessels where there should be three
- Abnormal three-vessel and trachea view
- A candy cane that became a hockey stick
- Sagittal views seal the diagnosis
- Head and neck vessels arising from the front artery
- Adding a third dimension
- The classic signs, in one place
- The look-alike with an overriding artery
- The look-alike with two swaps
What happens next
From the diagnosis scan to life after surgery
- The moment the diagnosis is made
- Watching through the rest of the pregnancy
- Why knowing beforehand changes the outcome
- The first hours after birth
- Holding the duct open with a drug
- Making a hole to let blood mix
- Two surgical routes
- The operation that puts the pipes back
- Switching at the atria instead
- A tunnel and a conduit
- over 90%
- Life after the switch
- The brain, not just the heart
Carry these away
What the referring clinician and the sonographer need
- What the referring physician needs to know
- The three key points
- If you remember nothing else
- Suggested readings
- References
- References (continued)
- References (continued)
- References (continued)
- Obstetric Imaging: Fetal Diagnosis and Care, 2nd Edition