Transpositions and malpositions of the great arteries

Yoo, S J; Park, J H; Han, M C; Lim, T H

Abstract

The trasposition of the great arteries refers to an abnormal connection and relation of the great arteries inwhich the aorta arises from the morphologic right ventricle and the pulmonary artery from the morphologic leftventricle, while the malposition of the great arteries are not transposed across the ventricular septum but theyare malposed,as is seen in double outlet right ventricle, double outlet left ventricle and single ventricles.Transpositions and malpositions of the great arteries are understood as a spectrum of malformation caused byabnormal conal development and can be included in the comon category of "conotruncal malpositions". Authorsanalized 32 cases of transpositions and mlapositions of the great arteries in which cineangiocardiographies weredone at the Department of Radiology, Seoul National University Hospital in recent 18 months, with specificreferences to the segmental combinations, the types of conus and the relations and courses of the great arteries.The results are as follows; 1. Cases incuded are 8 cases of complete transposition of the great arteries, 9 casesof corrected transposition of the great arteries, 12 cases of double outlet right ventricle, 1 case ofanatomically corrected malposition of the great arteries, 1 cases of double inlet left ventricle and 1 case ofdouble inlet right ventricle. 2. Segmental sets are {S.D.D} is 12, {S.L.L} in 13, {S,D,L} in 2, {I,L,L} in 2,{I,D,D} in 1, {A,L,L} in 1 and {A,D,X} in 1. 3. Types of conus are subaortic in 19 and bilateral in 13. In 19cases with subaortic conus, 17 are transposition of the great arteries and 2 are double inlet left ventricle anddouble inlet right ventricle. In 13 cases with bilateral conus, 12 are double outlet right ventricle and 1 isanatomically corrected malposition of the great arteries. 4. High tendency of side-by-side interrelationship ofsemilunar valves is noted in cases with corected transposition of the great arteries. But there is nocharacteristic tendency of side-by-side or anterior-posterior semilunar interrelationship in cases with completetransposition of the great arteris and double outlet right ventricle. 5. There are two cases of exception to "looprule". 6. There are two cases of exception to "visceroatrial concordance rule". 7. Inappropriate position ofaortic arch, i.e., right arch in situs solitus and left arch in situs inversus, is noted in 4 cases. 8. For moreaccurate diagnosis, selective biventriculography using biplane cineradiography is necessary.