P02.07: Prediction of emergency balloon atrioseptostomy at birth in transposition of the great arteries: a different approach

Abstract

Results: During the study period, 53 cases of RAA and 18 cases of DAA were prenatally diagnosed and postnatally confirmed. Among the 53 cases of RAA, 50 cases (94.3%) showed left ductal arch (LDA), and three (5.7%) had right ductal arch (RDA). Twenty-nine patients (54.7%) had mirror-image branching and 24 (45.3%) had an aberrant left subclavian artery, among which of four cases (7.5%) were associated with the Kommerell’s diverticulum. Of 12 patients who underwent chromosomal study, only one revealed abnormal karyotype, and there was no case with 22q11 microdeletion. All RAA patients did not show any symptoms related to tracheal or esophageal compression despite having a vascular ring and thus, did not require corrective surgery. Of the 18 DAA patients, four (22.2%) had symptoms and six (33.3%) underwent a corrective surgery at the median age of 22.5 months (range, 9–27 months). During surgery, five cases (27.7%) revealed right dominant arch, and one case (1.5%) had left dominant arch. chromosomal study was done for six patients (33.3%), and none of them had abnormal results. Conclusions: RAA and DAA can be prenatally detected by fetal echocardiography and may form a vascular ring that can possibly cause obstructive symptoms. However, even with vascular ring, RAA has an excellent prognosis without corrective surgery and DAA also has favorable outcomes after the surgical release of vascular ring.