Anatomically Corrected Malposition of the Great Arteries {S,D,L}
1998; Lippincott Williams & Wilkins; Volume: 97; Issue: 12 Linguagem: Inglês
10.1161/01.cir.97.12.1207
ISSN1524-4539
AutoresElizabeth D. Blume, Thomas K. Chung, Fredric A. Hoffer, Tal Geva,
Tópico(s)Cardiovascular Issues in Pregnancy
ResumoHomeCirculationVol. 97, No. 12Anatomically Corrected Malposition of the Great Arteries {S,D,L} Free AccessOtherPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessOtherPDF/EPUBAnatomically Corrected Malposition of the Great Arteries {S,D,L} E.D. Blume, T. Chung, F.A. Hoffer and T. Geva E.D. BlumeE.D. Blume From the Departments of Cardiology (E.D.B., T.G.) and Radiology (T.C., F.A.H.), Children's Hospital, and the Departments of Pediatrics (E.D.B., T.G.) and Radiology (T.C., F.A.H.), Harvard Medical School, Boston, Mass. , T. ChungT. Chung From the Departments of Cardiology (E.D.B., T.G.) and Radiology (T.C., F.A.H.), Children's Hospital, and the Departments of Pediatrics (E.D.B., T.G.) and Radiology (T.C., F.A.H.), Harvard Medical School, Boston, Mass. , F.A. HofferF.A. Hoffer From the Departments of Cardiology (E.D.B., T.G.) and Radiology (T.C., F.A.H.), Children's Hospital, and the Departments of Pediatrics (E.D.B., T.G.) and Radiology (T.C., F.A.H.), Harvard Medical School, Boston, Mass. and T. GevaT. Geva From the Departments of Cardiology (E.D.B., T.G.) and Radiology (T.C., F.A.H.), Children's Hospital, and the Departments of Pediatrics (E.D.B., T.G.) and Radiology (T.C., F.A.H.), Harvard Medical School, Boston, Mass. Originally published31 Mar 1998https://doi.org/10.1161/01.CIR.97.12.1207Circulation. 1998;97:1207B.M. is a previously healthy 18-year-old man referred for a second opinion on an abnormal echocardiogram. He had been followed in the first year of life for a nonspecific murmur. He presented again to medical attention secondary to Navy prequalification requirements and was referred to a local cardiologist. His physical examination, chest radiograph, and ECG were normal. On transthoracic and transesophageal echocardiograms performed in the referring institution, "the aorta did not connect to the left ventricle" and the superior aspect of the ventricular septum was "prominent." Cardiac MRI revealed levocardia with visceroatrial situs solitus and D-ventricular loop. The great arteries originated above the appropriate ventricles (ventriculoarterial concordance) (Fig 1), but their spatial position and orientation were abnormal: the aortic valve was anterior, superior, and leftward relative to the pulmonary valve and the great vessels were side-by-side (Figs 1 and 2). There was bilateral conus with aortic-mitral and pulmonary-tricuspid discontinuity and a well-developed subaortic chamber without obstruction. The patient had normal coronary anatomy and normal ventricular function.Anatomically corrected malposition of the great arteries is a rare form of congenital heart disease in which the great arteries are abnormally related to the ventricles and to each other but nonetheless arise above the anatomically correct ventricles. This abnormal relationship was first reported in 1895 by Theremin and was characterized by Van Praagh et al1 in 1975. In the absence of associated malformations, anatomically corrected malposition is associated with normal physiology and may be detected incidentally. MRI proved useful in establishing the diagnosis noninvasively in this patient with limited acoustic windows.The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke's Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke's Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.Download figureDownload PowerPoint Figure 1. Coronal T1-weighted MRI of chest demonstrates levocardia, atrial situs solitus, D-ventricular loop, and L-malposition of aorta with ventriculoarterial concordance. Aorta (AO) and main pulmonary artery (PA) arise above appropriate ventricles, but aortic valve is anterior, superior, and leftward relative to pulmonary valve and is supported by a conus. This image demonstrates unobstructed left ventricular outflow tract. LV indicates left ventricle; RA, right atrium; R, right; and S, superior.Download figureDownload PowerPoint Figure 2. Transverse T1-weighted MRI of chest at level of aortic (AO) and pulmonary (PA) roots demonstrates side-by-side relationship of great vessels, with aorta being to left of main pulmonary artery. A indicates anterior; LA, left atrium; R, right; and SVC, superior vena cava.FootnotesCorrespondence to Tal Geva, MD, Department of Cardiology, Children's Hospital, 300 Longwood Ave, Boston, MA 02115. E-mail [email protected] References 1 Van Praagh R, Durnin RE, Jockin H, Wagner HR, Korns M, Garabedian H, Ando M, Calder L. Anatomically corrected malposition of the great arteries. Circulation..1975; 51:20-31.CrossrefMedlineGoogle Scholar Previous Back to top Next FiguresReferencesRelatedDetailsCited By Sanders S and Toba S (2020) Unusual Ventriculo-Arterial Alignments and Connections, World Journal for Pediatric and Congenital Heart Surgery, 10.1177/2150135120905636, 11:3, (355-357), Online publication date: 1-May-2020. Valente A and Sanders S (2017) Complex Conotruncal Anomalies Practice of Clinical Echocardiography, 10.1016/B978-0-323-40125-8.00047-0, (936-949), . Ait Ali L, Sicari R and Festa P (2016) Anatomically corrected malposition of the great arteries: Review of the literature, Progress in Pediatric Cardiology, 10.1016/j.ppedcard.2016.07.006, 43, (113-117), Online publication date: 1-Dec-2016. Fallavollita L, Di Gioacchino L and Colaneri M (2016) Pregnancy in woman with anatomically correct malposition of the great arteries, International Journal of Cardiology, 10.1016/j.ijcard.2015.11.152, 204, (126-127), Online publication date: 1-Feb-2016. Zhao Y, Zhou Q, Zhang M, Shang Q and Peng Q (2015) Prenatal Diagnosis of Anatomically Corrected Malposition of the Great Arteries, Journal of Ultrasound in Medicine, 10.7863/ultra.34.8.1517, 34:8, (1517-1518), Online publication date: 1-Aug-2015. Saremi F (2014) Transposition of the Great Arteries Cardiac CT and MR for Adult Congenital Heart Disease, 10.1007/978-1-4614-8875-0_10, (225-258), . Saremi F, Ho S and Sánchez-Quintana D (2014) Right Ventricle Outflow Tract Cardiac CT and MR for Adult Congenital Heart Disease, 10.1007/978-1-4614-8875-0_7, (131-171), . Saremi F, Ho S, Cabrera J and Sánchez-Quintana D (2013) Right Ventricular Outflow Tract Imaging With CT and MRI: Part 1, Morphology, American Journal of Roentgenology, 10.2214/AJR.12.9333, 200:1, (W39-W50), Online publication date: 1-Jan-2013. Sivakumar K (2009) Catheter closure of an atrial septal defect in anatomically corrected malposition with left juxtaposition of atrial appendages, Cardiology in the Young, 10.1017/S1047951109990849, 19:5, (534-536), Online publication date: 1-Oct-2009. Chen M (2007) Anatomically Corrected Malposition of the Great Arteries, Pediatric Cardiology, 10.1007/s00246-007-9080-4, 29:2, (467-468), Online publication date: 1-Mar-2008. Bernasconi A, Cavalle-Garrido T, Perrin D and Anderson R (2006) What is anatomically corrected malposition?, Cardiology in the Young, 10.1017/S1047951106001326, 17:01, (26), Online publication date: 1-Feb-2007. Liske M, Kavanaugh-McHugh A and Parra D (2006) Isolated Infundibuloarterial Inversion, Pediatric Cardiology, 10.1007/s00246-005-1048-7, 27:2, (289-292), Online publication date: 1-Apr-2006. Mahrholdt H and Sechtem U (2002) Angeborene Herzkrankheiten und Kardiomyopathien Kardiovaskuläre Magnetresonanz-tomographie, 10.1007/978-3-642-57535-8_11, (75-91), . March 31, 1998Vol 97, Issue 12 Advertisement Article InformationMetrics Copyright © 1998 by American Heart Associationhttps://doi.org/10.1161/01.CIR.97.12.1207 Originally publishedMarch 31, 1998 PDF download Advertisement
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