Transposition of the great vessels other diagnostic studies

Transposition of the great vessels Microchapters
Home
Patient Information
Overview
Historical perspective
Classification
Dextro-transposition of the great arteries
L-transposition of the great arteries
Pathophysiology
Causes
Differentiating Transposition of the great vessels from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
Chest X Ray
MRI
CT
Echocardiography
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Palliative care
Corrective surgery
Post-operative care
Follow up
Prevention
Reproduction
Case Studies
Case #1
Transposition of the great vessels other diagnostic studies On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Transposition of the great vessels other diagnostic studies All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Transposition of the great vessels other diagnostic studies
CDC on Transposition of the great vessels other diagnostic studies
Transposition of the great vessels other diagnostic studies in the news
Blogs on Transposition of the great vessels other diagnostic studies
Directions to Hospitals Treating Type page name here
Risk calculators and risk factors for Transposition of the great vessels other diagnostic studies

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]

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.

Interventional

• Used while performing balloon atrial septostomy. This operation helps to increase mixing between the two circulatory systems.

ACC/AHA Guideline:Recommendation for Diagnostic Catheterization for Adults With Repaired Dextro-Transposition of the Great Arteries (DO NOT EDIT)

Class I

"1. *Diagnostic catheterization of the adult with d-TGA should be performed in centers with expertise in the catheterization and management of ACHD patients.(Level of Evidence: C) "

Class IIa

"1. For adults with d-TGA after atrial baffle procedure (Mustard or Senning), diagnostic catheterization can be beneficial to assist in the following: Hemodynamic assessment.(Level of Evidence: C) Assessment of baffle leak.(Level of Evidence: B) Assessment of superior vena cava or inferior vena cava pathway obstruction.(Level of Evidence: B) Assessment of pulmonary venous pathway obstruction.(Level of Evidence: B) Suspected myocardial ischemia or unexplained systemic RV dysfunction.(Level of Evidence: B) Significant left ventricular (LV) outflow obstruction at any level (LV pressure greater than 50% of systemic levels, or less in the setting of right ventricular [RV] dysfunction).(Level of Evidence: B) Assessment of pulmonary arterial hypertension (PAH), with potential for vasodilator testing.(Level of Evidence: C) "

"1. For adults with d-TGA, ventricular septal defect (VSD), and pulmonary stenosis (PS), after Rastelli-type repair, diagnostic catheterization can be beneficial to assist in the following: Coronary artery delineation before any intervention for right ventricular outflow tract (RVOT) obstruction.(Level of Evidence: C) Assessment of residual VSD.(Level of Evidence: C) Assessment of PAH, with potential for vasodilator testing.(Level of Evidence: C) Assessment of subaortic obstruction across the left ventricle-to-aorta tunnel.(Level of Evidence: C) "

ACC/AHA Guideline:Recommendations for Interventional Catheterization for Adults with Dextro-Transposition of the Great Arteries (DO NOT EDIT)

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) For adults with d-TGA after atrial baffle procedure (Mustard or Senning), interventional catheterization can be beneficial to assist in the following: Occlusion of baffle leak. (Level of Evidence: B) Dilation or stenting of superior vena cava or inferior vena cava pathway obstruction.(Level of Evidence: B) Dilation or stenting of pulmonary venous pathway obstruction.(Level of Evidence: B) 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) For adults with d-TGA, VSD, and PS, after Rastelli-type repair, interventional catheterization can be beneficial to assist in the following: 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) Device closure of residual VSD.(Level of Evidence: C) "