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Egg Shaped (Egg-on-a-String) Heart
Published in Michael E. Mulligan, Classic Radiologic Signs, 2020
The first description of the characteristic configuration of the heart in young patients with complete transposition of the great vessels is said to have been done by Helen Taussig1 in 1938. Many years later (1964) the term ‘egg-shaped’ was used in a report by Lewis Carey and Larry Elliott2 to describe this characteristic configuration. (Elliott had coined the phrase, personal communication). They reported a series of 47 patients with complete transposition and studied both the radiographs and necropsy specimens. ‘In the frontal projection, the configuration of the heart was usually quite characteristic: it was similar to the shape of an egg, tilted so that its long axis lay in an oblique direction. The pole with the least convexity lay upwards and to the right; the pole with the greatest convexity lay downwards and to the left’2 (Figure 1). Recognizing the abnormal shape of the heart is one of the key elements that will allow for a correct diagnosis in congenital heart disease cases. Other important factors include: position of the aortic knob, size of the main pulmonary artery, evaluation of the pulmonary vascularity and determination of visceral situs.
Cardiology
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
Transposition of the great arteries exists when the pulmonary artery originates from the left ventricle and the aorta from the right ventricle (Figs 5.14, 5.15). It is linked with maternal diabetes mellitus and is also found in association many other cardiac lesions. Somewhat confusingly the term transposition is used for two very different conditions: simple transposition and the less common congenitally corrected transposition; the latter is dealt with below in the ‘other lesions’ section.
The Dynamic Gracilis Procedure
Published in Han C. Kuijpers, Colorectal Physiology: Fecal Incontinence, 2019
C. G. M. I. Baeten, J. Konsten
Another advantage of the gracilis is that its normal function is not mandatory for all movements of the leg. After transposition all patients are able to walk, work, and to perform all types of sports without complaints. The gracilis muscle is technically an ideal muscle for a neo-anal function, but intrinsically a very bad muscle, as indicated before.
Meanings and functions of different types of heart images in the communication of doctors and patients
Published in Journal of Visual Communication in Medicine, 2023
Anna-Malin Karlsson, Theres Bellander
In this composition, the roles of image and language are reversed. The written text tells us about the poster’s child, who was born with a named and explained heart defect: “My youngest son was born with a heart defect which is called transposition, where the pulmonary artery and the aorta have switched places”. The post was made on Valentine’s Day (in Swedish Alla hjärtans dag, ‘The day of all hearts’), and the poster wanted to raise awareness about heart defects in children. The image can be seen as a resource for creating a more general focus on the heart defect as such, and less on the individual family and their experience. The post received one comment in the form of three hearts. The verbal text includes ten hashtags, one of which refers to the baby’s name. The remaining nine all refer to the heart defect, for example: #transposition, #allchildrensheartmonth, #theheartchildassociation.
Heart transplantation in adults with congenital heart disease: a 17-year single center experience
Published in Acta Cardiologica, 2023
Samuel Bruls, Vincent Tchana-Sato, Arnaud Ancion, Quentin Desiron, Jean-Paul Lavigne, Jean-Olivier Defraigne
At the time of transplantation, surgical access was median sternotomy in all cases. In most cases (n = 11), cardiopulmonary bypass was instituted by separated bicaval cannulation, arterial reinjection being carried out through the ascending aorta. In 4 cases, femoral artery cannulation had to be performed. Myocardial protection was performed by antegrade crystalloid cardioplegia in moderate hypothermia (30–32 °C). Additional surgical procedures or reconstructive surgery were necessary for 6 out of the fifteen patients with CHD (40%). In the three patients with transposition of the great arteries, anastomoses were adequately achieved through mobilisation and by obtaining an adequate length of donor aorta and pulmonary artery. Two patients required major reconstructive surgery of the pulmonary arteries. None of the vascular reconstructive procedures were performed with prosthetic material in our series of ACHD patients. The mean ischaemic time was 174 min (range 103–217 min) and the mean extracorporeal circulation time was 106 min (range 59–180 min). These times differed according to the complexity of the case. The mean ICU length of stay (LOS) was 18 d (range, 3–114). Patients were discharged from the hospital after a mean LOS of 42 d (range, 24–125). Hemodynamic and operative Characteristics of transplanted ACHD patients are summarised in Table 2.
Transposition of great arteries with coarctation of aorta: a rare association demonstrated on dual source CT
Published in Acta Cardiologica, 2021
Vineeta Ojha, Surya Pratap Singh, Kartik Ganga Ponnuswamy, Priya Jagia
A 1-month-old cyanotic child presented with recurrent lung infections and failure to thrive. All four limbs had adequate volume pulses. Arterial saturation was greater in lower limb arteries compared to the upper limb. Echocardiography revealed transposition of great arteries (TGA), however, the arch anatomy was not clear. Cardiac computed tomography angiography (CTA) was done on a 384-slice dual source scanner (Siemens Somatom Definition Force, Siemens, Munich, Germany) using ultra high pitch gated FLASH protocol. The review of the CTA images confirmed TGA with subpulmonic ventricular septal defect. Additionally, there was presence of juxta ductal coarctation of aorta with hypoplasia of distal arch. A good-sized patent ductus arteriosus (PDA) was present with mild narrowing at the aortic end. The narrowest coarcted segment measured 4.8 mm and the aorta just distal to it measured 14 mm (Figure 1(A,B)). Pulmonary arteries were grossly dilated, suggesting pulmonary hypertension (PAH).