2002, Number 3
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Arch Cardiol Mex 2002; 72 (3)
Obstruction of the outflow tracts of hearts with complete transposition of the great arteries
Muñoz CL, Kuri NM, Quiñones CAR
Language: Spanish
References: 24
Page: 192-202
PDF size: 786.23 Kb.
ABSTRACT
The obstructive lesions in the outflow tracts of hearts with complete transposition of the great arteries determine the clinical evolution, prognosis, and the selection of surgical procedures. Their knowledge is basic to interpret the imaging findings. From the pathologic specimens collection of the Instituto Nacional de Cardiología “Ignacio Chávez”, seventy-tree hearts with this cardiopathy were studied morphologically with the sequential segmental system. Thirty-two hearts had outflow tracts anomalies, being obstructive twenty-eight; among these lesions were: malposition of the infundibular septum, hipertrophyc left infundibulum, prolapse of tricuspid valve tissue through a ventricular septal defect, accessory mitral valve tissue, septal hipertrophy at the left outflow tract level, abnormal insertion of cord tendinae of the mitral valve, anticlockwise malposition of the mitral valve (first report in the literature). The left outflow tract presented obstructive lesions (92.85%) more frequently than the right one. These lesions produce left ventricular hipertrophy, a fundamental feature for the anatomic surgical procedures to be made.
REFERENCES
Lev M, Rimoldi HJA, Paiva R, Arcilla RA: The quantitative anatomy of simple complete transposition. Am J Cardiol 1969; 23: 409-416.
Van Praagh R: Transposition of the great arteries II. Transposition clarified. Am J Cardiol 1971; 28: 738-741.
Vogel M, Freedom RM, Smallhom JF, Williams WG, Trusler GA, Rowe RD: Complex transposition of the great arteries and coartation of the aorta. Am J Cardiol 1984; 53: 1627-1632.
Van Gils FAW: Left ventricular outflow tract obstruction in transposition with interventricular communication, anatomical aspects. In: Van Mierop LHS, Oppenheimer-Dekker A. and Bruins LLDCh. Embryology and teratology of the heart and the great arteries. Leiden University Press. The hafe, the Netherlands 1978; Pp 160-171.
Moene RJ, Oppenheimer-Dekker A, Werinink ACG, Bartelings MM, Gittenberger-De Groot: Morphology of ventricular septal defect in complete transposition of the great arteries. Am J Cardiol 1985; 55: 1566-1570.
Hoyer MH, Zuberbuhler JR, Anderson RH, Del Nidio P: Morphology of ventricular septal defects in complete transposition. Surgical implications. Thorac Cardiovasc Surg 1992; 104-1203-1211.
Hunta JC, Edwards WD, Danielson GK, Feld RH: Abnormalities of the tricuspid valve in complete transposition of the great arteries with ventricular septal defect. Thorac Cardiovasc Surg 1982; 83: 569-576.
Olibawio MN, Qwin K, Idriss FS, Riggs TW, DeLeon SY, Muster AJ, et al: The surgical management of left ventricular outflow tract obstruction due to tricuspid valve pouch in complete tranposition of the great arteries. J Thorac Cardiovasc Surg 1984; 87: 66-73.
Elliot LIP, Neufeld HN, Anderson RC, Adams P Jr, Edwards JE: Complete transposition of the great vassels. An anatomic study of 60 cases. Circulation 1963, 27: 1105-1117.
Meldrum-Hannan WG, Cartmill TB, Hawker RE, Celermajer JM, Wright CM: Accessory mitral valve tissue caussing left ventricular outflow tract obstruction. Br Heart J 1989; 55: 376-380.
Shivastava S, Todavarthy SM, Fukuda T, Edwards JE: Anatomic causes of pulmonary stenosis in complete transposition. Circulation 1989; 54: 154-159.
Sansa M, Tonkin IL, Bargeron LM, Elliot LP: Left ventricular outflow tract obstruction in transposition of the great arteries. An angiographic study of 74 cases. Am J Cardiol 1979; 44: 88-95.
Goor DA, Edwards JE: The spectrum of transposition of the great arteries with specific reference to developmental anatomy of the conus. Circulation 1973; 48: 406-415.
Van Praagh R, Van Praagh S: Isolated ventricular inversion. A consideration of the morphogenesis, definition and diagnosis of nontransposed and transposed great arteries. Am J Cardiol 1966; 17: 395-406.
Muñoz Castellanos L, Garcia Arenal F, Kuri Nivon M: Double infundibulum in congenital heart disease. Joint XIIth World Congress of Cardiology and XVIth Congress of the European Society of Cardiology. Eur Heart 1994; 15: 359.
Shaher RM: Complete transposition of the great arteries. New York. Academic Press. 1973; Pp 178-179.
Silove ED, Taylor JFN: Angiographic and anatomical features of subvalvular left ventricular outflow obstruction in transposition of the great arteries. The possible role of the anterior mitral valva leaflet. Pediatr Radiol 1973; 1: 87-91.
Tynan MJ, Becker AE, Macartney FJ, Quero-Jimenez M, Shinebourne EA, Anderson RH: Nomenclature and classification of congenital heart disease. Br Heart J 1979; 41: 544-553.
Barromee L, Lecompte Y, Batisse A, Lemoine G, Vouhe P, Sakata R, et al: Anatomic repair of anomalies of ventriculoarterial connection associated with ventricular septal defect. J Thorac Cardiovasc Surg 1988; 95: 96-110.
Chiu I, Anderson RH, Macartney FJ, De Leval MR, Stark J: Morphologic features of an intact ventricular septum susceptible to subpulmonary obstruction in complete transposition. Am J Cardiol 1984; 53: 1633-1638.
Jex RK, Puga FL, Julsurd PR, Weidman WH: Repair of transposition of the great arteries with intact ventricular septum and left ventricular outflow tract obstruction. J Thorac Cardiovasc Surg 1990, 100: 682-686.
Becker AE, Anderson RH: Cardiac Pathology. An integrated text and colour atlas. Abnormal ventriculo-arterial conexions. Edinburgh. Churchill Livingstone, 1982; Pp 165-178.
Jatene AD, Fontes VF, Paellista PP, Souze LCB, Neger F, Galantier M, et al: Anatomic correction of transposition of the great vassels. J Thorac Cardiovasc Surg 1976; 72: 364-370.
Rastelli GC, Wallance RB: Anatomic correction of transposition of the great arteries with ventricular septal defect and subpulmonary stenosis. J Thorac Cardiovasc Surg 1969; 58: 545-552.