CARDIOVASCULAR JOURNAL OF AFRICA • Vol 22, No 4, July/August 2011
204
AFRICA
anomalies depends on the systemic ventricular function.
6
At
an older age, the incidence of systemic ventricular dysfunction
and clinical congestive heart failure increases, even in patients
without concomitant anomalies. It has been reported that more
than one-third of these patients will suffer from congestive heart
failure by the fifth decade.
7
In addition, the morphological right
ventricle has an inherent vulnerability to developing failure
and there is a complex relationship between systemic ventricu-
lar dysfunction and the severity of AV valve regurgitation.
Therefore, surgery should be considered for significant AV valve
regurgitation before the appearance of irreversible ventricular
dysfunction.
8
With cc-TGA, coronary anomalies are occasionally present,
so evaluation of these coronary anomalies (origin, course and
distribution) is recommended.
9
Since our patient had only mild
symptoms and her AV valve regurgitation was also mild to
moderate, we prefer to follow her up periodically.
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Fig. 3. Parallel great vessels with aorta anterior and on
the left side.
Fig. 5. CT angiography showing the aorta arising from the
trabeculated right ventricle.
Fig. 4. CT angiography showing anteriorly located aorta.
Fig. 2. Hypertrabeculated left ventricle with moderate
band (physiological right ventricle loop).
