The Prevalence of Associated Congenital Cardiac Anomalies (Shunt-Dependent Lesions) in Children with Transposition of Great Artery

Abstract

BACKGROUND: Transposition of the great arteries (TGA) is a rare cyanotic heart disease associated with congenital cardiac anomalies; often called shunt-dependent lesions. Transposition of the great arteries is also linked to syndromic correlates. AIM: This study was to document the prevalence of TGA and various forms of shunt-dependent lesions in children with TGA. METHODS: This was a descriptive study where one thousand and five echocardiography were carried out in two health institutions over 9 years. RESULTS: Data were analyzed with IBM statistical software version 20. The prevalence of children with TGA was 1.7%. The majority of the infants, 73.3%, had ASD as shunt-dependent lesion. All the infants, 100.0%, presented with cyanosis, breathlessness, and poor weight gain. Less than one-tenth of the infants, 6.7%, had an intact septum. The highest proportion of the infants, 80.0%, has more than one congenital cardiac anomaly (shunt-dependent lesions). Infants with TGA have lower left ventricular mass (LVM) of 119.1 ± 116.5 compared with control (18.8 ± 12.6). This was statistically significant, Mann-Whitney U test (11.024), P < 0.001. The under-filled left ventricular mass was found in 73.3% of the infants. Infants with TGA co-existing with Teratology of Fallot (TOF) was (1/15) 6.7%; large Ostium secundum atrial septal defect was (OS ASD) (1/15) 6.7% and cases of ventricular septal defect (VSD) with associated ASD were (1/15) 6.7%. All infants had left aortic arch, which is a normal variant. None (0/15) had any surgical intervention as most were lost to follow-up. CONCLUSION: The prevalence of TGA was low in this setting. There were several shunt-dependent lesions associated with TGA. Atrial septal defect is the commonest. Poor management outcome was due to late presentation.