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D-Transposition of Great Arteries
Randy R. Richardson, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        TERMINOLOGY

        • Definitions

          • Aorta arises from right ventricle (RV) & pulmonary artery (PA) arises from left ventricle (LV)
          • Ventriculoarterial (VA) discordance with atrioventricular (AV) concordance
          • Category: Cyanotic, cardiomegaly, ↑ pulmonary vascularity
          • Hemodynamics
            • RV connected with systemic circulation: Pressure overload
            • LV connected with pulmonary circulation: Volume overload
            • Lethal without flow admixture: Patent foramen ovale (PFO), ventricular septal defect (VSD), patent ductus arteriosus (PDA)

        IMAGING

        • General Features

          • Radiographic Findings

            • CT Findings

              • MR Findings

                • Echocardiographic Findings

                  • Angiographic Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    Selected References

                                    1. Makadia LD et al: Diagnosis of anomalous origin of the right subclavian artery from the right pulmonary artery in a patient with D-transposition of the great arteries utilizing transthoracic echocardiography. Echocardiography. 37(12):2144-7, 2020
                                    2. Samyn MM et al: Echocardiography vs cardiac magnetic resonance imaging assessment of the systemic right ventricle for patients with d-transposition of the great arteries status post atrial switch. Congenit Heart Dis. 14(6):1138-48, 2019
                                    3. Wu K et al: Differential myocardial mechanics in volume and pressure loaded right ventricles demonstrated by cardiac magnetic resonance. Pediatr Cardiol. 40(7):1503-8, 2019
                                    4. Kirzner J et al: Long-term management of the arterial switch patient. Curr Cardiol Rep. 20(8):68, 2018
                                    5. Słodki M et al: New method to predict need for Rashkind procedure in fetuses with dextro-transposition of the great arteries. Ultrasound Obstet Gynecol. 51(4):531-6, 2018
                                    6. Khoshnood B et al: Impact of prenatal diagnosis on survival of newborns with four congenital heart defects: a prospective, population-based cohort study in France (the EPICARD Study). BMJ Open. 7(11):e018285, 2017
                                    7. Han BK et al: Multi-institutional evaluation of the indications and radiation dose of functional cardiovascular computed tomography (CCT) imaging in congenital heart disease. Int J Cardiovasc Imaging. 32(2):339-46, 2016
                                    8. Rickers C et al: Is the Lecompte technique the last word on transposition of the great arteries repair for all patients? A magnetic resonance imaging study including a spiral technique two decades postoperatively. Interact Cardiovasc Thorac Surg. 22(6):817-25, 2016
                                    9. Marín Rodríguez C et al: [Quality of 3D magnetic resonance imaging of coronary arteries in patients with D-transposition of the great arteries after the Jatene switch procedure.] Radiologia. 57(4):326-32, 2015
                                    10. van der Hulst AE et al: Cardiac MRI in postoperative congenital heart disease patients. J Magn Reson Imaging. 36(3):511-28, 2012
                                    11. Huang SC et al: Coronary artery anatomy in anatomically corrected malposition of the great arteries and their surgical implications. Eur J Cardiothorac Surg. 39(5):705-10, 2011
                                    12. Frank L et al: Cardiovascular MR imaging of conotruncal anomalies. Radiographics. 30(4):1069-94, 2010
                                    13. Manso B et al: Myocardial perfusion magnetic resonance imaging for detecting coronary function anomalies in asymptomatic paediatric patients with a previous arterial switch operation for the transposition of great arteries. Cardiol Young. 20(4):410-7, 2010
                                    14. Pettersen E et al: Left ventricular function in patients with transposition of the great arteries operated with atrial switch. Pediatr Cardiol. 29(3):597-603, 2008
                                    15. Raman SV et al: Usefulness of multidetector row computed tomography to quantify right ventricular size and function in adults with either tetralogy of Fallot or transposition of the great arteries. Am J Cardiol. 95(5):683-6, 2005
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Clinical Issues

                                          TERMINOLOGY

                                          • Definitions

                                            • Aorta arises from right ventricle (RV) & pulmonary artery (PA) arises from left ventricle (LV)
                                            • Ventriculoarterial (VA) discordance with atrioventricular (AV) concordance
                                            • Category: Cyanotic, cardiomegaly, ↑ pulmonary vascularity
                                            • Hemodynamics
                                              • RV connected with systemic circulation: Pressure overload
                                              • LV connected with pulmonary circulation: Volume overload
                                              • Lethal without flow admixture: Patent foramen ovale (PFO), ventricular septal defect (VSD), patent ductus arteriosus (PDA)

                                          IMAGING

                                          • General Features

                                            • Radiographic Findings

                                              • CT Findings

                                                • MR Findings

                                                  • Echocardiographic Findings

                                                    • Angiographic Findings

                                                      • Imaging Recommendations

                                                        DIFFERENTIAL DIAGNOSIS

                                                          PATHOLOGY

                                                          • General Features

                                                            • Gross Pathologic & Surgical Features

                                                              CLINICAL ISSUES

                                                              • Presentation

                                                                • Demographics

                                                                  • Natural History & Prognosis

                                                                    • Treatment

                                                                      Selected References

                                                                      1. Makadia LD et al: Diagnosis of anomalous origin of the right subclavian artery from the right pulmonary artery in a patient with D-transposition of the great arteries utilizing transthoracic echocardiography. Echocardiography. 37(12):2144-7, 2020
                                                                      2. Samyn MM et al: Echocardiography vs cardiac magnetic resonance imaging assessment of the systemic right ventricle for patients with d-transposition of the great arteries status post atrial switch. Congenit Heart Dis. 14(6):1138-48, 2019
                                                                      3. Wu K et al: Differential myocardial mechanics in volume and pressure loaded right ventricles demonstrated by cardiac magnetic resonance. Pediatr Cardiol. 40(7):1503-8, 2019
                                                                      4. Kirzner J et al: Long-term management of the arterial switch patient. Curr Cardiol Rep. 20(8):68, 2018
                                                                      5. Słodki M et al: New method to predict need for Rashkind procedure in fetuses with dextro-transposition of the great arteries. Ultrasound Obstet Gynecol. 51(4):531-6, 2018
                                                                      6. Khoshnood B et al: Impact of prenatal diagnosis on survival of newborns with four congenital heart defects: a prospective, population-based cohort study in France (the EPICARD Study). BMJ Open. 7(11):e018285, 2017
                                                                      7. Han BK et al: Multi-institutional evaluation of the indications and radiation dose of functional cardiovascular computed tomography (CCT) imaging in congenital heart disease. Int J Cardiovasc Imaging. 32(2):339-46, 2016
                                                                      8. Rickers C et al: Is the Lecompte technique the last word on transposition of the great arteries repair for all patients? A magnetic resonance imaging study including a spiral technique two decades postoperatively. Interact Cardiovasc Thorac Surg. 22(6):817-25, 2016
                                                                      9. Marín Rodríguez C et al: [Quality of 3D magnetic resonance imaging of coronary arteries in patients with D-transposition of the great arteries after the Jatene switch procedure.] Radiologia. 57(4):326-32, 2015
                                                                      10. van der Hulst AE et al: Cardiac MRI in postoperative congenital heart disease patients. J Magn Reson Imaging. 36(3):511-28, 2012
                                                                      11. Huang SC et al: Coronary artery anatomy in anatomically corrected malposition of the great arteries and their surgical implications. Eur J Cardiothorac Surg. 39(5):705-10, 2011
                                                                      12. Frank L et al: Cardiovascular MR imaging of conotruncal anomalies. Radiographics. 30(4):1069-94, 2010
                                                                      13. Manso B et al: Myocardial perfusion magnetic resonance imaging for detecting coronary function anomalies in asymptomatic paediatric patients with a previous arterial switch operation for the transposition of great arteries. Cardiol Young. 20(4):410-7, 2010
                                                                      14. Pettersen E et al: Left ventricular function in patients with transposition of the great arteries operated with atrial switch. Pediatr Cardiol. 29(3):597-603, 2008
                                                                      15. Raman SV et al: Usefulness of multidetector row computed tomography to quantify right ventricular size and function in adults with either tetralogy of Fallot or transposition of the great arteries. Am J Cardiol. 95(5):683-6, 2005