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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Diagnosed corrected transposition of great arteries after cesarean section: A case report
Naoki Ichii, Toshiyuki Kakinuma, Atsushi Fujikawa, Morihiko Takeda, Tomoyuki Ohta, Masataka Kagimoto, Ayaka Kaneko, Ryo Izumi, Kaoru Kakinuma, Koyomi Saito, Asako Maeyama, Kaoru Yanagida, Nobuhiro Takeshima, Michitaka Ohwada
Naoki Ichii, Toshiyuki Kakinuma, Masataka Kagimoto, Ayaka Kaneko, Ryo Izumi, Kaoru Kakinuma, Koyomi Saito, Asako Maeyama, Kaoru Yanagida, Nobuhiro Takeshima, Michitaka Ohwada, Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Japan
Atsushi Fujikawa, Morihiko Takeda, Department of Cardiovascular Medicine, International University of Health and Welfare Hospital, Tochigi 329-2763, Japan
Tomoyuki Ohta, Department of Radiology, International University of Health and Welfare Hospital, Tochigi 329-2763, Japan
Author contributions: Ichii N and Kakinuma T developed and drafted the manuscript; All authors designed the data collection instruments, collected data, and carried out the initial analyses, approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
Informed consent statement: The study was approved by the Ethics Committee of the International University of Health and Welfare Hospital (Approval date: June 10, 2021; Approval number 21-B-2). The patients provided consent after receiving written and verbal explanation of the study protocol.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Toshiyuki Kakinuma, MD, PhD, Doctor, Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, 537-3 Iguchi, Tochigi 329-2763, Japan. tokakinuma@gmail.com
Received: April 22, 2022
Peer-review started: April 22, 2022
First decision: June 8, 2022
Revised: June 17, 2022
Accepted: August 21, 2022
Article in press: August 21, 2022
Published online: September 26, 2022
BACKGROUND
Corrected transposition of the great arteries (cTGA) is a cardiac malformation in which the ventricular and arterial-ventricular positions in the heart are doubly reversed. In general, this defect puts a load on the systemic circulation and causes heart failure, resulting in a poor prognosis. This article reports a case of cTGA detected in a patient with post-caesarean pregnancy who had undergone elective caesarean section and was experiencing an episode of acute heart failure.
CASE SUMMARY
This was the case of a 36-year-old gravida 3 para 1 woman. No problems were noted in the puerperal course following the previous pregnancy. The current pregnancy was also uneventful. An elective caesarean section was performed and the patient was discharged from the hospital 7 d after the operation. On postoperative day 18, the patient became aware of breathing difficulty and presented at a nearby clinic, where she was referred to our institution after bilateral pleural effusions were detected. She was then diagnosed with acute heart failure after noting the presence of a prominent pedal oedema and SpO2 91% (supine position and room air); the patient was promptly hospitalised for close examination and treatment. Although chest computed tomography revealed the presence of cTGA, no other cardiac malformations were observed. Owing to improvements in both the pedal oedema and pleural effusions, the patient was discharged on day 9.
CONCLUSION
Close examination should be performed on the premise of congenital cardiac malformation when heart failure symptoms are noted during perinatal control.
Core Tip: Corrected transposition of the great arteries (cTGA) is a rare disorder that accounts for only less than 1% of all congenital heart diseases. Cases with no associated cardiac anomalies are even rarer, accounting for only 5% of all cTGA cases. We reported a case of cTGA that was detected on the occasion of acute heart failure following elective caesarean section carried out on a patient with post-caesarean pregnancy. Close examination should be performed on the premise of congenital cardiac malformation when symptoms of heart failure are noted during perinatal control.
