Transposition with VSD

  • The Aorta arises from the right ventricle and receives "blue" blood, whilst the Pulmonary Artery arises from the left ventricle. In addition there is a Ventricular Septal Defect (VSD). The baby may become blue immediately after birth, but sometimes the diagnosis is delayed as the degree of cyanosis (blueness) can be very mild with this combination of problems. Survival depends on the amount of oxygenated blood in the left side of the heart which can reach the aorta through the VSD or via the ductus or the Foramen Ovale in the early days of life. The Foramen Ovale can be enlarged with a catheter procedure, called Balloon Septostomy, which is
    performed in the first few days of life. This involves a catheter with a balloon at the tip, which is passed from a leg vein until the balloon is in the left atrium (across the Foramen Ovale). The balloon is then inflated and the catheter is pulled back to the right atrium.

    18d_Transposition_of_the_great_arteries

    Early surgery is essential and involves the "Arterial Switch Operation", which is carried out in the early months of life with repair of the VSD at the same time and corrects the abnormality. The small coronary arteries, which feed the heart muscle with blood, need to be transferred as well as the two Great Arteries (Aorta and Pulmonary Artery).

    18b_Transposition_of_the_great_arteries

    Until aroud 1980 this delicate surgery could not be performed safely and an alternative procedure was used, redirecting blood within the atriums.  This was called a "Senning" operation. (The "Mustard" operation was very similar