Cardiology in the Young

Original Article

Intensive care management of neonates with d-transposition of the great arteries and common arterial trunk

Pirouz Shamszada1, Ryan A. Moorea1, Nancy Ghanayema2 and David S. Coopera1 c1

a1 The Heart Institute, Cincinnati Children's Hospital Medical Center, University of Cincinnati School of Medicine, Cincinnati, Ohio, United States of America

a2 The Herma Heart Center, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America

Abstract

Although mortality rates for patients with d-transposition of the great arteries remain quite low, these patients have a unique circulation that requires careful management in the peri-operative period. Despite the improved mortality for patients with common arterial trunk, the course in the intensive care unit is remarkable for significant morbidity and utilisation of significant resources. Pre-operative patient management focuses on balancing competing circulations, pulmonary and systemic, which exist in parallel rather than in series, as in the normal circulation. Post-operative patient management in both lesions focuses on optimising systemic output, respiratory status, and mitigating the effects of cardiopulmonary bypass. In this article, we review pre- and post-operative intensive care management in neonates with d-transposition of the great arteries and common arterial trunk.

Keywords

  • D-transposition of the great arteries;
  • truncus arteriosus;
  • peri-operative care;
  • intensive care;
  • 22q11 deletion

Correspondence:

c1 Correspondence to: Dr D. S. Cooper, MD, MPH, The Heart Institute, Cincinnati Children's Hospital Medical Center, University of Cincinnati School of Medicine, 3333 Burnet Avenue, MLC 2003, Cincinnati, Ohio 45229, United States of America. Tel: 513 803 1801; Fax: 513 636 3952; E-mail: David.Cooper@cchmc.org