By Donald N. Ross B. Sc., M. B., CH. B., F. R. C. S. (auth.)
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Extra info for A Surgeons’ Guide to Cardiac Diagnosis: Part II The Clinical Picture
Corrected transposition compared with the great vessels in transPosition and a normal heart Fig. 14. Angiocardiogram showing the disposition of the great vessels in corrected transposition. The aorta arises on the left border of the heart Such a condition is known as corrected transposition and really represents a condition of ventricular transposition. The external coronary artery pattern of the ventricles is often transposed, and the tricuspid and mitral valve mechanism Total Anomalous Pulmonary Venous Drainage 23 is also usually transposed within the ventricular cavities.
Both the presence of symptoms and an increased heart size suggest a severe obstruction. A right ventricular strain pattern electrocardiographically has a similar significance. Treatment should aim at relief of the obstruction before these features suggesting depleted cardiac reserves are prominent. The presence of cyanosis brought about by the reversal or an atrial communication generally means a considerable right ventricular pressure and calls for urgent surgical relief. In this country a right ventricular strain pattern or increasing strain pattern on the electrocardiograph has been considered an indication for surgery.
Complete heart block is fairly common in this condition. This may be congenital or may develop during cardiac catheterisation or anaesthesia. The incidence of block is so high following attempts at surgical closure of ventricular septal defects in this condition that many surgeons prefer not to operate on these cases. Total Anomalous Pulmonary Venous Drainage Definition This is a condition in which the pulmonary veins drain into a common chamber or trunk which, in turn, communicates directly with the right atrium.