What medicine does infantile big artery transposition take good?

summary

Transposition of the great arteries refers to the connection between the right atrium and the right ventricle, which sends out the aorta, while the left ventricle connects with the left atrium and sends out the pulmonary trunk. Transposition of the great vessels, also known as transposition of the great vessels, is a congenital malformation in which the aorta and the pulmonary artery exchange anatomically, resulting in the abnormality of systemic circulation and pulmonary circulation. It is the most common cyanotic congenital heart disease in the neonate. The incidence rate is 0.2 to 0.3 per thousand, accounting for 5% to 7% of the total number of congenital heart diseases. Second of the cyanotic congenital heart disease patients, the ratio of male to female is 2 to 4:1. The incidence rate of the mother with diabetes is 11.4 times higher than that of the normal mother. The incidence rate of the pregnant women who use hormone and anticonvulsant drugs is higher. If not treated, about 90% of the patients died within one year old. What medicine does infantile big artery transposition take good?

What medicine does infantile big artery transposition take good?

The occurrence of transposition of the great vessels is closely related to the torsion of the cardiovascular system and the development and separation of the conus arteriosus in the fetal period. The occurrence and anatomical classification of this disease are quite complicated, and different references are made. In brief, cardiac tube torsion occurred at 5-6 weeks of gestation. The right ventricle is on the right and the left ventricle is on the left. The aortic conus is located at the lower right posterior and the pulmonary conus is located at the upper left anterior. During the development of the heart tube, if the left loop turns, or the conus arteriosus originating from the ventricle does not spiral but develops and separates straightly, the position of the right ventricle on the left, the left ventricle on the right, or the aorta on the right, and the pulmonary artery on the right will change.

If complete transposition of the great arteries is not accompanied by other malformations, two parallel loops are formed. The venous blood from superior vena cava and inferior vena cava supply the whole body through the right heart to the transposed aorta, while the oxygenated blood from pulmonary vein supply the lung through the transposed pulmonary artery through the left heart. Patients must rely on intracardiac communication (patent foramen ovale, atrial septal defect, ventricular septal defect) or extracardiac communication (patent ductus arteriosus, collateral vessels) for blood flow mixing. The hemodynamic changes of this disease depend on whether it is associated with other malformations, the degree of communication and mixing of left and right cardiac blood and whether the pulmonary artery is narrow or not.

Most of them begin within one month. With the increase of age and activity, the cyanosis gradually increased. Cyanosis is systemic, if combined with patent ductus arteriosus, there will be differential cyanosis, cyanosis in the upper limb is more serious than that in the lower limb.

matters needing attention

If there is no appropriate size of atrial septal defect, the ductus arteriosus can be kept open until surgery. For infants with severe hypoxia, intravenous infusion of prostaglandin E1 or prostaglandin E2 should be performed immediately before being transferred to a tertiary hospital to dilate the arterial catheter. For those with metabolic acidosis, sodium bicarbonate can be injected intravenously to correct the acidosis.