ABSTRACT
The authors present a case report of a 12-year-old boy with diagnosis of transposition of the great arteries and ventricular septal defect, who underwent an arterial switch operation plus closure of the septal defect. On follow-up, left ventricular outflow tract obstruction was detected, initially mild. Last year, he started complaining of fatigue on exercise. Severe subaortic stenosis was diagnosed and surgical repair was performed with good results. Subaortic stenosis is a rare complication on follow-up of patients who have undergone an arterial switch operation, particularly those with transposition of the great arteries and ventricular septal defect.
Subject(s)
Aortic Valve Stenosis/etiology , Postoperative Complications/etiology , Transposition of Great Vessels/surgery , Child , Humans , MaleABSTRACT
UNLABELLED: Permanent junctional reciprocating tachycardia is an infrequent form of reentrant supraventricular tachycardia but is the commonest incessant tachycardia in childhood. The persistent nature of the tachycardia can lead to heart failure secondary to left ventricular dysfunction and the arrhythmia is often refractory to drug control. STUDY OBJECTIVE: To review the main clinical features and therapeutic options currently available for this arrhythmia. DESIGN: Retrospective study. PATIENTS: A group of 5 children with a diagnosis of permanent junctional reciprocating tachycardia. RESULTS: Age at presentation ranged between 14 days and 12 years. Three were asymptomatic. The first echocardiogram displayed left ventricular dilation and decreased shortening fraction in one child. Pharmacological therapy was initially successful in all. During follow-up (0.2-4.5 years) the arrhythmia became resistant to medication in one case and radiofrequency ablation was carried out. CONCLUSIONS: Permanent junctional reciprocating tachycardia has a wide range of clinical presentations. Pharmacological therapy is recommended, but radiofrequency ablation is the definitive treatment and only depends on patient age.
