title: Transarterial approach of the pulmonary artery in anatomically corrected malposition of the great arteries by manipulating a catheter inverted with balloon floating maneuver.
abstract: We describe two neonates with anatomically corrected malposition of the great arteries (ACM). A 1-day-old female newborn, who had the salient clinical findings of Goldenhar syndrome, behaved like a patient with the tetralogy of Fallot. The cardiac malformations included ACM, perimembranous inlet and outlet ventricular septal defect with tricuspid valve straddling, conoventricular septal malaligement, bilateral cori without aortic-mitral continuity, pulmonary stenosis at subvalvular, valvular, and supravalvular levels, and bicuspid semilunar valves. After the procedure of left Blalock-Taussig shunt at 3 months of age, cyanosis was alleviated. The other 1-month-old male newborn, who presented with prolonged feeding, tachypnea and tachycardia, likened to a patient with the hypoplastic left heart syndrome. He had a combination of ACM, mitral stenosis, hypoplastic left atrium and left ventricle, a restrictive patent foramen ovale, ventricular septal defect, subaortic conus without aortic-mitral continuity, subaortic stenosis, and a narrow ascending aortic root. Rashkind balloon atrioseptostomy was done with limited success. He survived a Norwood procedure. Transarterial entry of the catheter, which was inverted with the aid of balloon floating maneuver, to hook the retro-aortic pulmonary artery in ACM is recommended.
authors.affiliation: Department of Pediatrics, Changhua Christian Hospital, Taiwan.
authors.forename: M L
authors.initials: ML
authors.lastname: Lee
authors.forename: I S
authors.initials: IS
authors.lastname: Chiu
authors.forename: M H
authors.initials: MH
authors.lastname: Wu
authors.forename: J K
authors.initials: JK
authors.lastname: Wang
authors.forename: H C
authors.initials: HC
authors.lastname: Lue
authors.forename: W T
authors.initials: WT
authors.lastname: Chaou
authors.forename: L Y
authors.initials: LY
authors.lastname: Tsao
mesh_terms: D000792:Angiography; D006328:Cardiac Catheterization / Q000295:instrumentation / Q000379:methods*; D004452:Echocardiography; D005260:Female; D006053:Goldenhar Syndrome / Q000150:complications; D006321:Heart / Q000000981:diagnostic imaging; D006330:Heart Defects, Congenital / Q000150:complications; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011651:Pulmonary Artery; D014188:Transposition of Great Vessels / Q000150:complications / Q000175:diagnosis*