Transposition Of The Great Vessels

Question: What is the chance of a child being born with Transposition of the great Arteries? a heart defect? I have a son who was born with a congenital heart defect, Transposition of the Great Arteries (or Vessels). Heart defects are the number 1 defects for live births, occurring in 1 out of every 100 births. Now, what are the odds for a child to be born with Transposition (i.e. 1 in ___ births), as it is pretty common?

Answer: Actually congenital heart defects occur in 1 of every 125-150 children, so they are quite common. Of all heart defects, 5% will be transposition of the great arteries, occurring overall at a rate of 2-3 per 10,000 births. Transposition is more common in boys than girls.

Question: TWO ECG QUESTIONS -What does a SAH look like on ecg? What does transposition of greater vessels look lk on ecg? (sah = sub arachnoid haemorrhage) thanks

Answer: Subarachnoid hemorrhage is bleeding into the submeningeal plane (also called the "pia mater") of the brain. It has nothing to do with the heart. The most common reason for subarachnoid hemorrhage is injury. The next most common is bleeding from a ruptured cerebrovacular aneurysm (often in a small vessel like the posterior communicating branch). These phenomena are located inside the skull and have absolutely no relationship with the electrophysiology of the heart. SAH causes no ECG changes. Transposition of the great vessels is a congenital malformation with severe hemodynamic and pulmonary vascular consequences. This is a problem noted in newborn babies. There are varations on the anatomy of this malformation as well as associated phenomena such as additional congenital abnormalities of the heart, vertebral malformations, anorectal abnormalities, kidney problems and limb deformities. The diagnosis of transposition is made against the background of having an OBVIOUS cardiac abnormality in a newborn. The question isn't if, but what the abnormality is. ECG is not part of the evaluation for babies with congenital cardiac anomalies. This is characterized using echocardiography and contrast angiography or CT angiograms. ECG is used for the detection of abnormalities of the electrical conduction system of the heart. Because of the array of electrodes, a 3-dimensional estimation can be made of where in the heart-muscle the conduction disturbance is located. Because known patterns of ECG abnormality are associated with specific types of heart muscle injury, the ECG can actually help locate which artery has been blocked in an acute heart attack. Additionally, specific rhythm disturbances are obvious on ECG, and the difference between heart muscle that is suffering from poor oxygen levels (ischemia) and dead heart muscle (old "myocardial infarct") is also evident. ECG is used to detect abnormalities in the adult heart.

Question: Anyone with a child that was born with Heart defects that is going to Preschool or already has? Pleas answer? My now 3 year old son was born with transposition of the great vessels and 3 other heart defects. He is doing great now and plays just like any other three year old with the exception he needs a few more breaks. My son will be starting preschool soon and I am worried about bullying and if he would get hit in his chest. I know there are very few bully's in preschool but I am still worried. What precautions did you take keep them safe?

Answer: I personally played the concerned parent and told his teacher as well as the principal and school nurse about my sons heart defects that way they knew that he needed a few more breaks then the other kids and that way they knew that if anything were to happen then they knew exactly what could be the problem. Then with giving them all of the emergency contact information in case something did happen I felt safe sending my kid to school knowing that he would be okay.

Question: Can I get a Tattoo if I have a heart condition? When I was three days old, I had open heart surgery, due to a blood circulation problem. I would really like to get a tattoo, but I don't know if it's safe. Has anyone ever had problems like mine and gotten a tattoo, please speak up. The type of operation I had was called transposition of the great vessels. They were both in the wrong place. I don't have any limitations, I can run, jog, swim, and I do, I love to work out. I'm even a smoker... Nothing bothers my heart @ all. Thanx

Answer: Note: don't rely on us; talk to a doctor. We're just a bunch of folks with vague to intense interests in tattoos, and your life & health are worth seeing a professional. That said... I think the operative word here should be "had" a heart condition. If you can do all you mention with no problems, and appear as young as you are, I can't believe the minor pain of a tattoo would bother you. If it did, things like visiting a dentist would be a real adventure. I have found some mentions of a badly done transposition causing problems, but that's something a doctor can determine & seems like it's only an issue when taking medical anticoagulants and involved in semi-major surgery. A tattoo wouldn't even count as an outpatient procedure. If the operation was done well, you're likely good to go.

Question: What are the complications with a premature(34 weeks) male newborn missing a chromosome? He was born with transposition of the great vessel, also very small at birth(2lbs 1 oz)

Answer: Normally, the pulmonary artery carries venous (bluish) blood from the right ventricle to the lungs to get oxygen. Then the aorta carries the oxygen-rich (red) blood from the left ventricle to the body. In transposition of the great arteries, the vessels are reversed. The aorta is connected to the right ventricle so that venous (bluish) blood is carried to the body. The pulmonary artery is attached to the left ventricle so that oxygen-rich (red) blood is carried back to the lungs. Infants born with transposition survive only if they have one or more connections that let oxygen-rich (red) blood reach the body. These connections may be in the form of a hole between the two atria (atrial septal defect), the two ventricles (ventricular septal defect), or a vessel connecting the pulmonary artery with the aorta (patent ductus arteriosus). Most babies with transposition of the great arteries are extremely blue soon after birth because these connections are not adequate. To improve the body's oxygen supply, a special procedure called balloon atrial septostomy is used during heart catheterization. It enlarges the atrial opening and helps the baby by reducing the cyanosis. Two general types of surgery may be used to help correct the transposition. One common surgical procedure creates a tunnel inside the atria. It redirects oxygen-rich (red) blood to the right ventricle and aorta, and redirects venous (bluish) blood to the left ventricle and pulmonary artery. This operation is called a venous switch or intra-atrial baffle procedure. It has other names, too, including the Mustard procedure or the Senning procedure. It's usually done in infancy. Many factors, including the degree of cyanosis, determine how early in life a child may need surgery. In another surgical procedure, the major arteries are switched. The aorta is connected to the left ventricle, which pumps oxygen-rich (red) blood to the body. The pulmonary artery is connected to the right ventricle, which pumps venous (bluish) blood to the lungs. This arterial switch procedure may be done in the first few weeks after birth or, depending on various factors, slightly later. If there's a large ventricular septal defect or other defects related to the transposition, the repair gets more complicated. Then other surgical procedures may be needed. After surgery, the long-term outlook varies quite a bit. It depends largely on how severe the defects were before surgery. Lifelong follow-up is needed to be sure that any remaining defects or problems are treated properly. Children with transposition of the great arteries are at risk for getting an infection on the heart's walls or valves (endocarditis) before and after surgery. To help prevent endocarditis, they should be given antibiotics such as amoxicillin before dental work and certain surgeries. Good dental hygiene also lowers the risk of endocarditis. For more information about dental hygiene and preventing endocarditis, ask your pediatric cardiologist.

Question: Transposition of the great vessels- who is the musard procedure named after?

Answer: Dr. Michael Gatzoulis of the Royal Brompton Hospital, London, England, working with Dr. Liu, examined 51 patients who 25 years ago had received the Mustard procedure in Toronto. They found that nearly a quarter of the sample were beginning to develop heart rhythm problems which, left untreated could lead to heart failure. The Mustard procedure – developed by Dr. William Mustard with support from the Heart and Stroke Foundation of Canada– was the first operation to correct the congenital abnormality that produced “blue babies. Blue babies are born with a defect called transposition of the great vessels, in which blood from the lungs flows back to the lungs and blood from the body flows back to the body. The two major arteries coming out of the heart, the aorta and the pulmonary artery are connected to the wrong chambers. Such babies look blue because insufficient oxygen is circulating in their bodies. The Mustard procedure restores the circulation but reverses the direction of the blood flow in the heart. In a normal heart, de-oxygenated, blue, blood is pumped into the lungs via the right ventricle. Then it is distributed throughout the body via the left ventricle. In the Mustard procedure, blood is pumped to the lungs via the left ventricle and disseminated throughout the body via the right ventricle.

Question: Clinically how to differentiate between anomalous pulmonary venous return & transposition of great vessels? On seeing snowman or figure-of-eight heart sign of chest X-ray, clinically how to differentiate between anomalous pulmonary venous return & transposition of great vessels as the underlying disease? (by location of murmur maybe??) Thanks ganga. Clinically if I give you a snowman CXR, how would you tell me from history and/or physical examination what the most likely cause is (tetralogy of fallot, vs anomalous pulmonary venous return, vs transposition of great vessels)?

Answer: Total anomalous pulmonary venous connection (TAPVC), also known as total anomalous pulmonary venous drainage (TAPVD) and total anomalous pulmonary venous return (TAPVR), is a rare cyanotic congenital heart defect (CHD) in which all four pulmonary veins are malpositioned and make anomalous connections to the systemic venous circulation.(Normally, pulmonary venous return carries oxygenated blood to the left atrium and to the rest of the body). A patent foramen ovale or an atrial septal defect must be present, or else the condition is fatal due to a lack of systemic blood flow. A Partial anomalous pulmonary venous connection is a congenital defect where right atrium is the point of return for the blood from some (but not all) of the pulmonary veins. It is less severe than total anomalous pulmonary venous connection. It can be diagnosed with angiography or echocardiography. Total anomalous pulmonary venous return (TAPVR) correction * TAPVR occurs when the pulmonary veins bring oxygen-rich blood from the lungs back to the right side of the heart, instead of to the left side of the heart, where it should be. * This condition requires surgery to correct it. When the surgery is done will depend on how sick the baby is. The surgery may be done in the newborn period if the infant has severe symptoms. If it is not done right after birth, it is done in the first 6 months of the baby’s life. * TAPVR repair requires an open-heart surgery. The pulmonary veins are attached to the left side of the heart, where they belong, and any abnormal connections are closed. * If a PDA is present, it is tied off and divided. Transposition of the great vessels (TGV) is a group of congenital heart defects (CHDs) involving an abnormal spatial arrangement of any of the primary blood vessels: superior and/or inferior vena cavae (SVC, IVC), pulmonary artery, pulmonary veins, and aorta. CHDs involving only the primary arteries (pulmonary artery and aorta) belong to a sub-group called transposition of the great arteries (TGA). Transposition of the great vessels repair * In a normal heart, the aorta comes from the left side of the heart, and the pulmonary artery comes from the right side. Transposition of the great vessels is when these arteries come from the opposite sides of the heart. * Correcting transposition of the great vessels requires open-heart surgery. If possible, this surgery is done shortly after birth. * The most common repair is an arterial switch. The aorta and pulmonary artery are divided. The pulmonary artery is connected to the right ventricle, where it belongs. Then, the aorta and coronary arteries are connected to the left ventricle, where they belong.

Question: What would it take to move to Australia, and gain citizenship? I am currently in college, and will be receiving a bachelor's degree in Secondary Education for History and Government in about 3-4 years from an institution in Kansas. It is very plausible for me to have a wife and child(ren) by then. What would it take to move to somewhere in Eastern Australia? What is the difference between a permanent residence visa and citizenship in Australia? Are teachers needed in Australia (esp. for history and gov.)? My plausible "wife-to-be" may not have any formal Secondary Education at that point. Would they prevent us from emigrating because of that? How would the degree transfer? I have also heard they have strict health standards; I have Transpositions of the Great Vessels, which I have had surgery for, and haven't had any problems with for a long time. Would they "discriminate" against me for it? I'm sure there are lots of other questions and answers that I have not listed, that I would like to know about. Please be as specific and elaborative as possible.

Answer: Our immigration laws are very strict. If you have any skills that are in great need here, then you will have a foot in the door, no worries. Permanent Residency is when you are living here permanently...you will be given a green card, but that does not give you citizenship. Should you apply for citizenship and it's granted, this gives you all the same rights as an Australian citizen...i.e., the right to vote. As far as your wife to be goes, as long as you have the finances to support her and your children, I think they should be okay. Not sure about your health, as I have no idea what that is. Go online and google some Aussie Immigration websites that will give you the straight answers you need. Good luck! :)

Question: Anyone else with TGV (congenital heart disease) had a baby??? I was born with a complicated heart condition (transposition of the great vessels) and I have a mechanical mitral valve and a pacemaker. Has anyone known anyone with this condition that has had a baby???

Answer: First: you really need to consult a cardiologist for an answer. The combination of issues, your medications, your general health, your family history -- all will influence the answer. I did not find any reports in the medical literature of a case with all three of the conditions you listed: transposition of the great vessels, mechanical mitral valve and a pacemaker. Taken individually, pregnancy can be managed sucessfully. The combination may be quite different! Transposition of the great vessels The medical literature shows that while quite risky, some women with transposition of the great arteries have had successful pregnancies. Mechanical mitral valve The literature attests to a number of births to women with mechanical valves. Note that essential medications may be teratogenic (cause birth defects.) Pacemaker No major problems are reported with the pacemaker & pregnancy.

Question: 24 yr old male with testosterone lvl of 440, is that low? I also have multiple cardiac problems....? 1. Is that low for my age range? The doctor told me anything from 300-1200 is considered normal.....I tried looking through the internet and it seems like all the sites that were saying that yes that is indeed too low, were pushing to sell testosterone treatments. So i don't know how solid their advice is. 2. The reason I got this test is I am experiencing increasing frequent ED problems. I am in right sided heart failure, I have pulmonary stenosis and a heart murmur. At the of 6 I had open heart surgery to correct VSD resulting in transposition of the great vessels....I am taking coreg(a beta blocker) and lisinopril daily.....so i assumed the of being able to perform in bed was a result of all of the above. When i confronted the doc with why my bedtime fun is going to the crapper he suggested the testosterone test, which leads me to my question because when i went to talk to him about the results he seemed very much in a hurry, told me i was within the norm range and i said what about my sexual problems, he replied with "well we will have to do another testosterone test in 3 months because one isn't enough" the ED is creating rifts between my partner and I and I do not want to wait 3 more months for an answere, suggestions? ...thank you, it feels good to vent

Answer: A testosterone level of 440 is normal. The testosterone level varies during the course of a 24 hour cycle, usually peaking around 7 AM. Assuming your test was drawn at another time it is very normal. Beta blockers are well recognized to cause ED, and to a lesser degree ACE inhibitors (like lisinopril). Neither of these medications is a contraindication to using a medication like Viagra. Check with your cardiologist to see if he has any issues with you using Viagra, Levitra or Clialis.