Complete transposition of the great vessels

The arterial switch operation before Jatene

Attempts at the arterial switch operation predated the Senning and the Mustard venous switch procedures. No patients survived the earlier arterial switch methods. Therefore, from the 1960s to the 1980s, venous switch surgeries became the dominant treatment method for transposition of the great arteries. The Brazilian cardiac surgeon, Adib Jatene, reported the first successful arterial switch in 1975. The history of the earlier arterial switches performed in the 1950s and 1960s is not well known. This article discusses that early history.

The vectorcardiogram in complete transposition of the great vessels. Analysis of fifty cases

The Frank vectorcardiograms of 50 patients with complete transposition of the great vessels were analyzed, and the findings were correlated with the electrocardiogram and hemodynamics. The patients were divided into four groups according to the presence or absence of ventricular septal defect and left ventricular outflow tract obstruction. In group I, consisting of 20 patients with ventricular septal defect, the vector cardiograms showed evidence of combined ventricular hypertrophy in 80% of the cases, the scalar electrocardiogram, in 40%.

In group II, 13 patients with ventricular septal defect and left ventricular outflow tract obstruction, the vectorcardiogram was consistent with either right, combined, or left ventricular hypertrophy.

In groups III and IV, patients with intact ventricular septum with or without left ventricular outflow tract obstruction, the vectorcardiogram was consistent with right ventricular hypertrophy in the majority of cases.

The electrocardiogram in complete transposition of the great vessels

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Cardiac pain in association with mitral stenosis and congenital heart disease

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Congenital tricuspid atresia

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Necropsies in some congenital diseases of the heart, mainly Fallot's tetralogy

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Transposition of the great vessels

The vast majority of cases of transposition of the great vessels can be diagnosed in the first few weeks of life with electrocardiogram, x-ray and fluoroscope. The clinical pattern and the diagnostic features are described in detail. The degree of cyanosis, the characteristic heart shape and progressive increase in size coupled with generous hilar shadows all suggest this diagnosis. A new suggestion is made regarding possible surgical therapy using an extracorporeal circulation.