CTICasesUncorrected D-Transposition of the Great Arteries
Imaging findings
Chest radiograph in a 25-year-old man shows cardiomegaly and markedly increased pulmonary vascularity without pleural effusions, Kerley lines, or peribronchial cuffing. Echocardiography and CT demonstrate d-transposition of the great arteries with a dilated, hypertrophied right ventricle, severe tricuspid regurgitation, and a large atrial septal defect.
Key takeaways
Uncorrected transposition of the great arteries (TGA) in adulthood is exceedingly rare and requires a large, non-restrictive interatrial communication (such as an atrial septostomy) to allow sufficient mixing of systemic and pulmonary blood for survival. On chest radiography, the classic appearance of increased pulmonary blood flow without interstitial pulmonary edema in a cyanotic adult is a key clue to an uncorrected left-to-right or mixing shunt.
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