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Ref Number = PITIKA-ASPR0357
CASE SERIES - DELAYING THE FATALITY OF PARALLEL CIRCULATION
Bayushi Eka Putra
Background: Transposition of the Great Arteries is considerably a fatal disease which needs timely operative surgery. The time limit of three to four weeks is very short considering the limited amount of centers capable of doing the curative arterial switch operation. Therefore, late presenters of parallel circulation, in this case, associated with intact ventricular septum will be piling up in the regional areas. Palliative procedures involving less invasive procedure, and can be done peripherally, namely transcatheter procedure, is thought to play an important role.
Case illustration: Two cases of late presenters Transposition of the Great Arteries with Intact Ventricular Septum (TGA-IVS) came to the emergency room. The first case already underwent balloon atrial septectomy and patent ductus arteriosus (PDA) stenting at a relatively late presentation. Meanwhile, the second case underwent IVS went PDA stenting followed by interatrial stenting after admission. Both have a different course of the disease, one fell into lung overflow after the procedure; the others progress nicely with an improvement of the marker of infection. The size of PDA stent and the size of iatrogenic interatrial connection were thought to play a role in the course of disease in those two patients.
Conclusion: Transcatheter approach can be a choice to be done in district hospital as palliative treatment in late presenter of TGA-IVS to stabilize the patient as a bridge for arterial switch operation procedure. It is a great candidate as a replacement for Blalock-Taussig shunt and pulmonary artery banding which were already a standard treatment. Thus preventing two stage surgery for late presenter of TGA-IVS
Keywords: TGA-IVS, late presenter, PDA stenting, interatrial stenting
Disclaimer: The Views and opinions expressed in the articles are of the authors and not of the journal.
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