A five day old, full term male infant was severely cyanotic at bih. Prostaglandin E was administered initially and later ballooned atrial septosomy was done which showed improvement in oxygenation. The most likely diagnosis of this infant is -
Ans. is 'b' i.e., Transposition of great vessels Transposition of Great vessels is a condition characterized by aoa arising from the right ventricle and pulmonary aery from the left ventricle. This results in complete separation of systemic and pulmonary circulation. Since systemic and pulmonary circulations are separate, survival depends on mixing of oxygenated pulmonary blood and deoxygenated systemic blood which can occur: At Atrial level Through ASD At Ventricle level Through VSD At Great vessel level . Through Patent ductus aeriosus Oxygenation is normal in foetus but after bih as ductus aeriosus closes severe hypoxia occurs and in the absence of VS.D, or ASD child presents with cyanosis and tachypnea at bih. Jantene aerial switch procedure is surgical treatment of choice and should be performed within first 2 weeks of life. Aoa and pulmonary aery are divided just above the sinuses and reanastomosed in correct anatomical positions. The coronary aeries are then removed from old aoic root along with a button of aoic wall and reimplanted in the old pulmonary root. Other operations available : Aerial switch operation by Mustard and Senning.
Tetralogy Fallot
Transposition of great vessels
Truncus Aeriosus
Tricuspid Atresia