Complete Transposition of the Great Arteries in the Pediatric Field: A Multimodality Imaging Approach
Sara Moscatelli,
Martina Avesani,
Nunzia Borrelli,
Jolanda Sabatino,
Valeria Pergola,
Isabella Leo,
Claudia Montanaro,
Francesca Valeria Contini,
Gabriella Gaudieri,
Jessica Ielapi,
Raffaella Motta,
Marco Alfonso Merrone,
Giovanni Di Salvo
Affiliations
Sara Moscatelli
Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital, London WC1N 3JH, UK
Martina Avesani
Division of Paediatric Cardiology, Department of Women and Children’s Health, University Hospital of Padua, 35128 Padua, Italy
Nunzia Borrelli
Adult Congenital Heart Disease Unit, AO Dei Colli-Monaldi Hospital, 80131 Naples, Italy
Jolanda Sabatino
Experimental and Clinical Medicine Department, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
Valeria Pergola
Dipartimento di Scienze Cardio-Toraco-Vascolari e Sanità Pubblica, University Hospital of Padua, 35128 Padua, Italy
Isabella Leo
Experimental and Clinical Medicine Department, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
Claudia Montanaro
Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton Hospital, Guy’s and St. Thomas’ NHS Foundation Trust, London SW3 5NP, UK
Francesca Valeria Contini
Clinical Cardiology Unit, Department of Medical Sciences and Public Health, University Hospital of Cagliari, Strada Statale 554, Km 4.500, 09042 Monserrato, Italy
Gabriella Gaudieri
Adult Congenital Heart Disease Unit, AO Dei Colli-Monaldi Hospital, 80131 Naples, Italy
Jessica Ielapi
Experimental and Clinical Medicine Department, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
Raffaella Motta
Dipartimento di Scienze Cardio-Toraco-Vascolari e Sanità Pubblica, University Hospital of Padua, 35128 Padua, Italy
Marco Alfonso Merrone
Clinical Pathways and Epidemiology Unit, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy
Giovanni Di Salvo
Division of Paediatric Cardiology, Department of Women and Children’s Health, University Hospital of Padua, 35128 Padua, Italy
The complete transposition of the great arteries (C-TGA) is a congenital cardiac anomaly characterized by the reversal of the main arteries. Early detection and precise management are crucial for optimal outcomes. This review emphasizes the integral role of multimodal imaging, including fetal echocardiography, transthoracic echocardiography (TTE), cardiovascular magnetic resonance (CMR), and cardiac computed tomography (CCT) in the diagnosis, treatment planning, and long-term follow-up of C-TGA. Fetal echocardiography plays a pivotal role in prenatal detection, enabling early intervention strategies. Despite technological advances, the detection rate varies, highlighting the need for improved screening protocols. TTE remains the cornerstone for initial diagnosis, surgical preparation, and postoperative evaluation, providing essential information on cardiac anatomy, ventricular function, and the presence of associated defects. CMR and CCT offer additional value in C-TGA assessment. CMR, free from ionizing radiation, provides detailed anatomical and functional insights from fetal life into adulthood, becoming increasingly important in evaluating complex cardiac structures and post-surgical outcomes. CCT, with its high-resolution imaging, is indispensable in delineating coronary anatomy and vascular structures, particularly when CMR is contraindicated or inconclusive. This review advocates for a comprehensive imaging approach, integrating TTE, CMR, and CCT to enhance diagnostic accuracy, guide therapeutic interventions, and monitor postoperative conditions in C-TGA patients. Such a multimodal strategy is vital for advancing patient care and improving long-term prognoses in this complex congenital heart disease.
