Late Presentation of D-TGA Complicated by Functional Glenn Shunt Obstruction Led to SVC Syndrome 10 Years Later: a Rare Case Report

Salaheldin E.O.; Arriola-Montenegro L.; Yaseen A.; ElTohamy A. · SN Comprehensive Clinical Medicine (2023) · DOI: 10.1007/s42399-023-01517-w

Resumen

Dextro-transposition of the great arteries (D-TGA) is a congenital heart defect in which the pulmonary artery and aorta anomalously originate from the left and right ventricles, respectively. D-TGA is managed surgically in the first days of life. We describe a case of a patient with D-TGA who was managed at the age of 4 years. A Glenn shunt operation with pulmonary artery banding was performed to prepare the left ventricle for a second, definitive corrective surgery. The patient did not return for the definitive surgery. Ten years later at the age of 14, the patient started developing edema of the face and arms and was managed for bleeding esophageal varices. At the age of 19, she presented to our care with difficulty breathing and was diagnosed with superior vena cava (SVC) syndrome due to a failure of pulmonary artery banding. Glenn shunt with pulmonary artery banding was done for this patient with D-TGA at the age of 4 years, when the primary arterial switch operation was contraindicated. Pulmonary artery banding failure caused a functional obstruction of her Glenn shunt and, consequently, SVC syndrome.

Instituciones: Universidad Peruana de Ciencias Aplicadas