Mavroudis - L-TGA

ccTGA Mav25

-AV & VA discordance

-might at usual or inverted atrial arrangement

-major assoc xx

-VSD (>75% pts)

-valvar or subvalvar PS (LVOTO- but remember LV is on R side/pulm side) - LVOTO in >50% pts

-TV malformations (TV on L side/systemic side) --> systemic AV vlv regurg

-abNl coronary arts

-abNl conduction system - anterior AV nd/His bundle, complete HB (congen or post op)

-GA xx- Ao often ant/left of PA, nearlly side/side, but variable

Nomenclature

-ccTGA

-discordant transposition

-AV & VA discordance

-physiologically corrected transposition

-double discordance

-AV discordance w transposition

-L-transposition

-Inverted transposition

-mixed levocardia/mixed dextrocardia

-dextroversion

-SLL = situs solitus, L looped, L transposed GAs

-or IDD - situs inversus, D looped, D transposed GAs

Anatomy

-usually atrial situs solitus w LV on R and RV on L, but w LV slightly post and inf to RV

-mirror image if atrial situs inversus

-AV vlvs stay w their ventricle

-malposition of hrt common

-apex usually leftward, and formed by RV

-1/4 pts have dextrocardia, some w mesocardia

-dextrocardia- assoc w dextrorotation of hrt, so RA is more posterior

-mirror image if atrial inversus