Dextro-transposition of the great arteries cardiac catheterization
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Dextro-transposition of the great arteries/complete transposition of the great arteries Microchapters |
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Differentiating dextro-transposition of the great arteries from other Diseases |
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Diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Cafer Zorkun, M.D., Ph.D. [3]; Keri Shafer, M.D. [4]; Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [5]
Overview
Cardiac catheterization –
Diagnostic
Cardiac catheterization is not frequently done to diagnose transposition of the great vessels, as it could be done confidently with echocardiography. It is in conditions when the echo findings are inconclusive. It can be used to determine the coronary anatomy.
Recommendations for Interventional Catheterization for Adults with Dextro-Transposition of the Great Arteries
Class IIa
1. Interventional catheterization of the adult with d-TGA can be performed in centers with expertise in the catheterization and management of ACHD patients. (Level of Evidence: C) 2. For adults with d-TGA after atrial baffle procedure (Mustard or Senning), interventional catheterization can be beneficial to assist in the following:
- 1. Occlusion of baffle leak. (Level of Evidence: B)
- 2. Dilation or stenting of superior vena cava or inferior vena cava pathway obstruction. (Level of Evidence: B)
- 3. Dilation or stenting of pulmonary venous pathway obstruction. (Level of Evidence: B)
3. For adults with d-TGA after ASO, interventional catheterization can be beneficial to assist in dilation or stenting of supravalvular and branch pulmonary artery stenosis. (Level of Evidence: B) 4. For adults with d-TGA, VSD, and PS, after Rastelli-type repair, interventional catheterization can be beneficial to assist in the following:
- 1. Dilation with or without stent implantation of conduit obstruction (RV pressure greater than 50% of systemic levels, or peak-to-peak gradient greater than 30 mm Hg; these indications may be lessened in the setting of RV dysfunction). (Level of Evidence: C)
- 2. Device closure of residual VSD. (Level of Evidence: C)