Congenitally corrected transposition of great arteries associated with
Interrupted aortic arch type A, complex and rare anatomy detected by
Echocardiography.
Abstract
Here we report an extremely rare case of congenitally corrected
transposition of great arteries (CCTGA) associated with Interrupted
aortic arch (IAA) type A and ventricular septal defect (VSD) in a
preterm baby. Antenatally diagnosed as large VSD and severe Coarctation
of aorta. Echocardiogram done revealed that left ventricle with the
mitral valve lay on the right side in continuation with the venous right
atrium and was connected to the pulmonary artery. The right ventricle
lay on the left in continuation with the arterial left atrium and was
connected to the aorta. Smallish transverse arch with Interruption of
aorta below the left subclavian artery. Large VSD with bidirectional
shunt. Small PDA with restrictive right to left flow. As far we know,
only one similar case was reported earlier by Cottrell, at el. (4). At
that time the initial diagnosis was done by cardiac angiography as 2D
color echocardiography was not available at their center, after one year
they were able to use echocardiogram and same diagnosis was confirmed.
In our case despite the complex anatomy we were able to diagnose our
case by 2D color Echocardiogram. The Echocardiogram images and loops
were so clear and confirmative that no other cardiac imaging was
required. Baby was stable clinically on prostaglandin and underwent
successful aortic arch repair (end to end anastomosis) and PA banding.
We believe that Echocardiography still is a basic tool for diagnosis of
complex congenital cardiac anomalies specially in centers where other
higher diagnostic modalities are still not available.