Egyptian Journal of Radiology and Nuclear Medicine
Case report of coexisting transposition of the great arteries with supracardiac total anomalous pulmonary venous connection: focus on computed tomography features
Yusuf Syaeful Nawawi1* , Indah Purnama Sari1 , Ida Prista Maryetty1 , Rachmi Fauziah Rahayu1 and Sri Lilijanti Widjaja2
Background. The coexisting of transposition of the great arteries (TGA) with total anomalous pulmonary venous connection (TAPVC) is one of the rare anomalies. The incidence of coexisting TAPVC and TGA is unknown with very few cases ever reported.
Case presentation. We reported a case of a 13-month-old female toddler with history of cyanosis. Echocardiography revealed atrioventricular ambiguity with pulmonary atresia, all PVs drain into the innominate vein via vertical vein (VV), ostium secundum atrial septal defect (ASD) and ventricular septal defect (VSD) were observed. The CT scan confrmed co-occurrence of TGA and TAPVC. All four confuence PVs behind the small left atrium (LA), drains into an ascending lateral large VV, coursing to innominate vein without any PV access into LA. The superior vena cava, right atrium and right ventricle (RV) were dilated. The RV is the origin of the aortic root. The aorta continues on the right side, with an arterial connection to the right pulmonary aberrant artery at the level of the aortic arch. Main pulmonary artery originates from LV and appears atretic with only connection to the left pulmonary artery. Large ASD and VSD were identifed.
Conclusions. TGA and TAPVC are a rare combination and should be suspected in mild-cyanotic cases with levocardia with situs solitus. CT angiography is one of the modalities of choice to characterize the vasculature anomalies.
Keywords. Transposition of the great arteries, Total anomalous pulmonary venous connection, CT angiography, Case report
*Correspondence: Yusuf Syaeful Nawawi email@example.com 1 Department of Radiology, Faculty of Medicine, Dr. Moewardi Hospital, Universitas Sebelas Maret, Jl. Kolonel Sutarto No. 132, Jebres, Surakarta, Central Java 57126, Indonesia 2 Department of Pediatric, Faculty of Medicine, Dr. Moewardi Hospital, Universitas Sebelas Maret, Surakarta, Central Java, Indonesia