Transposition of the Great Arteries (D-TGA)

35 yr old, male with a history D-TGA (dextro-Transposition of the Great Arteries) sometimes also referred to as complete transposition of the great arteries, which is a birth defect where the large arteries of the heart, (aorta and pulmonary artery) are transposed. This patient had undergone an atrial switch procedure at 3 months of age. He has been treated for pulmonary hypertension and congestive heart failure and, now complains of increasing shortness of breath and fatigue with routine activity.
In D-TGA, the deoxygenated blood entering the heart gets pumped directly to the body without going through the lungs, and oxygenated blood coming from the lungs gets sent back to the lungs rather than out to the body. Many people with TGA are born with a ventricular septal defect (VSD- a hole between the two sides of the heart) that allows oxygenated blood to be distributed throughout the body. If there isn’t a hole present at birth, doctors will make a temporary hole to keep the infant alive until an atrial switch procedure can be done.

https://www.youtube.com/watch?v=O83cYwKOKtI

In this case, data from a CT scan was post-processed by the 3DQ Lab to produce MIP (maximum intensity projection) images. These MIPs allow the radiologist to better visualize the tortuosity of the patients’ vasculature and to see the anatomy as a whole. When comparing the most recent study with the previous study done in 2011, it is much easier to see the progression of this condition when evaluating the post processed images. However, since the obvious progression of the patients’ disease does not correlate to the patients’ complaints, further testing will need to be done such as lab work or stress test.