Dear Doctor, i want to know the prognosis of my 9 months old niece. her medical diagnosis is-
D-transpositions of great arteries
Decompressed and banana shaped LV
ADV.two stage ASO/senning operation.
I am writing You from Bangladesh. This diagnosis is done by local Doctors. If you inform me kindly more about this, specially the diagnosis, it will help me a lot.
Waiting for your mail.
d-Transposition of the great arteries is a serious congenital heart defect that results in severe cyanosis (blueness). Usually if surgery is not performed in the first few days to weeks of life, then the child cannot survive. If the child has an atrial septal defect (ASD) of good size and/or a patent ductus arteriosus (PDA) that allows more "red" blood to go to the body and allows for a longer survival. That seems to be the case here, since the child is 9 months old. However, the right sided pumping chamber is doing the major work of the body and that is why the LV is "banana shaped". The simplest surgery to perform would be a Senning, where the blood flow from the upper chambers is channeled towards the opposite pumping chamber. This surgery has a high rate of success at many ages, and allows the child to become "pink", but the RV remains the main pumping chamber. There are late onset complications with this operation such as need for pacemaker or medications for rhythm problems, or heart failure. The arterial swiych operation (ASO) is the preferred operation, but it is usually done in the first week of life. Later than that, the heart needs to be "prepared" by banding the pulmonary artery before the switch (2 stages). This is a much more complicated endeavor and it is not as successful at this age as the Senning would be. The decision as to which surgery should be performed will be made by the doctors caring for her, but should be done at a center that cares for children with complex congenital heart disease. Good luck.
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