G. Rainey Williams

Incomplete transposition of the great vessels (Taussig-Bing complex)

Abstract The physiologic studies of 6 cases of the Taussig-Bing type of incomplete transposition of the great vessels are presented. The diagnosis was confirmed at autopsy in 3 cases. The anterior position of the pulmonary artery was noted at surgery in 2 of the other 3 patients. Although most of the previously reported cases were in older children or adults, all of our patients were under 4 years of age and 5 of the 6 were infants. Cyanosis, although present in all the infants, was only of mild degree in contrast to the marked to moderate cyanosis in older children and adults previously reported. The striking clinical feature of the small infants was pulmonary congestion resulting from markedly increased pulmonary blood flow. They masqueraded clinically as patients in congestive heart failure due to acyanotic congenital heart disease with large left-to-right shunts. Angiographic studies arc usually necessary to locate the great vessels accurately and to make an exact diagnosis. Young patients with the Taussig-Bing complex, in contrast to most older patients with this syndrome, show large pulmonary blood flows, low pulmonary vascular resistances and a clinical picture of severe left-sided congestive heart failure. For these reasons, decreasing the pulmonary pressure and flow by pulmonary artery banding seemed a reasonable palliative surgical approach for treatment and was attempted in 3 infant patients. One patient died at surgery. The other 2 survived and have exhibited clinical improvement, and are now 12 and 15 months postoperative.