Summary: Sequential images from the helical CT examination demonstrate
the trabeculated morphologic "right" ventricle on the left side
communicating with the morphologic "left" ventricle via a
ventricular septal defect [figure 2]. The aorta arises from the
"right" ventricle and lies anterior to the pulmonary artery and to
the left of midline [figure 3]. Sagittal reconstruction again shows
the anterior lying aorta and demonstrates the critical subpulmonic
stenosis [figure 4]. The patient subsequently underwent successful
repair of his ventricular septal defect and pulmonic stenosis.
Congenitally corrected transposition of the great vessels
Congenitally corrected transpositon refers to atrioventricular
discordance, ventricular inversion, transposition and inversion of
the great arter-ies.1
This is a rare condition, with an
incidence of approximately 1 in 13,000 live births. It is estimated
that 1% of these cases are uncomplicated (i.e., with no associated
These patients rarely live beyond
the age of fifty; however, there is a case on record of a patient
living to be 80 years old.3
Most afflicted patients die
young due to associated congenital anomalies or heart
Findings in these cases have been described on
plain chest films, angiography and echocardiography.5
MRI and computed tomography imaging also have been
All findings on cardiac catheterization of this
patient were well visualized with helical CT. One advantage of
helical CT is the rapidity of the study [30 seconds]. The short
scan time allows for breath-hold imaging, thus minimizing motion
artifacts. It also enables optimal timing of the bolus to obtain a
continuous data set without an interval. This data set can then be
used for multiplanar reconstructions. In this patient, data set
images and reconstructions clearly delineated the transposed
arteries and the ventricular septal defect, as well as the
subpulmonic stenosis. Review of images in the cine mode can give
valuable information about the direction of shunting.
- Perloff JK:Congenitally corrected
transposition of the great arteries. In: The Clinical Recognition
of Congenital Heart Disease, pp 62-83. Philadelphia, WB Saunders
- Losekoot TG, Anderson RH, Becker AE, et al
(eds): Congenitally corrected transposition, pp 1-191.
London, Churchill Livingston, 1983.
- Pezard PP, Banus Y, Laporte J, et al:
Transposition Corrigee Des Gros Vaisseaux De L'Adulte Age. Arch Mal
Coeur 79:1637-1642, 1986.
- Ikeda U, Furuse M, Suzuki O, et al:Long term
survival in aged patients with corrected transposition of the great
arteries. Chest 5:1382-1385, 1992.
- Tonkin IL, Kelley MJ, Bream PR, Elliott LP:
The frontal chest film as a method of suspecting transposition
complexes. Circulation 53:1016-1025, 1976.
- Park JH, Han MC, Kim CW: MR Imaging of
congenitally corrected transposition of the great vessels in
adults. AJR 153:491-494, 1989.
- Schlesinger AE, Hernandez RJ: Congenital heart
disease: Applications of computed tomography and magnetic resonance
imaging. Semin Ultrasound CT MR 12:11-27, 1991.