Abstract
Introduction. Conotruncal anomalies are considered to be one of the most complex congenital heart lesions because of the absence of standard surgical protocol as well as lack of precise anatomical criteria for their differentiation. The latter may explain the existence of the so called transitional anatomical forms of conotruncal anomalies, in particular between Taussig–Bing anomaly (TB) and simple transposition of the great arteries (TGA). As one of the basic demarcative criteria may serve the interrelationship of the arterial trunks. In this article we demonstrate the results of measurements of the truncal rotation in patients with TB and simple TGA using computed morphometry.
Objective. Forty-five patients with TB and simple TGA undergone CT-angiography. Embryological truncal rotation was measured as an angel between the axis of arterial valves and frontal plane in axial CT scans.
Results. The average truncal rotation degree in TB and simple TGA groups amounted to 0° (–68°, 10°) and –93° ± 14° (–80°–(–128°)), respectively. In all cases among the two groups the arterial trunks were arranged in a parallel fashion. TB patients tended to have a right-sided aorta while in simple TGA group aorta was located anterior or anterior and left to the pulmonary artery.
Conclusion. TB anomaly is an anatomical predecessor of all TGA forms. Simple TGA develops as a result of the anomalous leftward truncal rotation and the degree of the rotation is much more than that in TB anomaly. Different types of TGA with ventricular septal defects by the degree of truncal rotation lay between simple TGA and TB anomaly. When leftward truncal rotation is occurs, the arterial trunks are always arranged in a parallel fashion.
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About the authors
- Konstantin V. Shatalov, Dr. Med. Sci., Professor, Head of Department; ORCID
- Konstantine M. Dzhidzhikhiya, Cand. Med. Sci., Cardiac Surgeon; ORCID
