Publication

Abstract : Patients with dextro-transposition of the great arteries (d-TGA) with an intact ventricular septum (IVS) beyond 21 days of age may develop left ventricular (LV) regression. Perioperative echocardiography-guided assessment of LV for signs of regression is crucial in decision-making for definitive corrective surgery, namely arterial switch operation (ASO), as a regressed LV may not be capable of sustaining the load of systemic circulation. We hereby present transesophageal echocardiography (TEE) findings in a child with d-TGA and regressed LV where decision to perform a primary ASO with integrated extracorporeal membrane oxygenation (ECMO)- cardiopulmonary bypass (CPB) circuit was made. Use of ECMO was planned as a standby technique in the event of LV failure. ECMO was eventually used as the LV was unable to sustain the load of systemic circulation after ASO.