Misdiagnosis rate of transposition of great arteries?
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. The trunk of an artery in vertebrates that radiates to all parts of the body.
Misdiagnosis rate of transposition of great arteries?
The occurrence of transposition of great vessels is closely related to the volvulus of cardiovascular system and the separation of healthy search of conus arteriosus during 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
In neonates with transposition of the great arteries with intact ventricular septum, the exchange blood flow between the two major circulation is less. There is obvious cyanosis (cyanosis is obvious in neonates with intact ventricular septum and inadequate blood mixing), which can be found within a few hours after birth and is the only symptom in most cases. Physical examination shows obvious cyanosis, normal peripheral vascular pulse and enhanced right ventricular pulse. During auscultation, the first and second heart sounds are loud, and the second heart sound is often single or slightly split. The soft heart murmur or absence of soft ejection murmur can be caused by functional left ventricular outflow tract murmur or patent ductus arteriosus.
When pulmonary artery stenosis is caused by left ventricular outflow tract obstruction, cyanosis is obvious, and a loud systolic ejection murmur can be heard on the left upper edge of sternum. The clinical manifestations are similar to tetralogy of Fallot except that the aortic valve is close to the anterior chest wall and makes the second heart sound louder. It is necessary to pay attention to the presence of left ventricular outflow tract obstruction in ventricular septal defect with malalignment. If the femoral artery pulse is weakened and the arm artery pulse is normal or enhanced, it may be accompanied by aortic arch interruption or edema. In addition, the upper body may be more cyanotic than the lower body.
matters needing attention
The first choice of treatment for this disease is to inject prostaglandin E intravenously, keep the arterial catheter open or perform balloon atrial septal defect dilation, so as to provide enough systemic pulmonary arterial blood shunt and maintain the oxygen saturation of systemic arterial system. If the treatment is not enough to relieve hypoxemia, atrial septal enlargement should be performed at 4-8 months to increase the blood communication between the two circulation and maintain the survival of the child. When they grow up to 2-3 years old, they will undergo corrective surgery, such as intraatrial blood flow diversion (mustard or Senning) or arterial blood flow diversion.
