Successful arterial switch operation for transposition of the great arteries with intact ventricular septum and congenital diaphragmatic hernia: A case report

Abstract We report performing a successful arterial switch operation on a full-term male infant with transposition of the great arteries and intact ventricular septum associated with a congenital diaphragmatic hernia. The patient developed severe persistent pulmonary hypertension after successful repair of a left congenital diaphragmatic hernia that restricted pulmonary blood flow into the hypoplastic left lung, and subsequent unilateral pulmonary congestion of the unaffected right lung occurred because of the hemodynamics generated by the transposition of the great arteries. Intravenous epoprostenol with nitric oxide inhalation and mechanical hypoventilation effectively controlled pulmonary vascular resistance before the arterial switch operation was performed. Learning Objective: The outcome of this case suggests that administration of intravenous epoprostenol with nitric oxide inhalation effectively treats persistent pulmonary hypertension of the newborn. Moreover, the hemodynamics associated with transposition of the great arteries requires controlled mechanical hypoventilation to effectively treat pulmonary congestion.>