Transposition of the Great Arteries with Borderline Right Ventricle, Ventricular Septal Defect, and Aortic Arch Obstruction

Abstract

A male neonate with transposition of the great arteries, ventricular septal defect, coarctation of the aorta, and a moderately hypoplastic right ventricle was transferred to our hospital. Following initial bilateral pulmonary artery banding, the arterial switch operation with ventricular septal defect closure and coarctation repair was performed, while atrial septal defect was left open. Two years after the operation, the diameter of the tricuspid valve annulus was found to be 10.8 mm (Z-score: −2.73), and bidirectional flow through atrial septal defect was observed on echocardiography. The patient underwent one and a half ventricular repair at 3 years of age. Thirteen years after the third operation, the patient is in a good general condition with normal sinus rhythm. At the latest investigation on echocardiography, no sign of right heart failure is observed; no dilatation of the inferior vena cava, no reversal flow in the inferior vena cava, and no right ventricular systolic dysfunction. The tricuspid valve diameter is 25.3 mm with balanced left and right ventricular cavities.