Congenitally corrected transposition of the great arteries and situs inversus in an octogenarian with systemic right ventricular failure: Usefulness of cardiovascular magnetic resonance with delayed-enhancement to detect extensive myocardial scars

Mikio Shiba, Shigefumi Fukui, Hideo Ohuchi, Jin Ueda, Akihiro Tsuji, Yoshiaki Morita, Aya Miyazaki, Takeshi Ogo, Satoshi Yasuda, Isao Shiraishi, Norifumi Nakanishi

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Systemic right ventricular (RV) failure in patients with congenitally corrected transposition of the great arteries (ccTGA), a major cause of mortality in the long-term follow-up, is usually induced by concomitant severe morphologically tricuspid regurgitation (TR) with/without Ebstein’s anomaly or progressive conduction tissue disturbances. However, whether or not myocardial fibrosis is a common cause of systemic RV failure in patients with ccTGA remains unclear. Here, we describe an 82-year-old man who had been diagnosed previously as having uncomplicated ccTGA and situs inversus and recently developed systemic RV failure, which was neither associated with severe TR nor advanced conduction tissue abnormalities. Cardiovascular magnetic resonance (CMR) with delayed-enhancement imaging clearly detected extensive myocardial scars (presumably fibrosis) in the RV wall as well as prominent dilatation, hypertrophy, and systolic dysfunction of the systemic RV. These findings suggest that myocardial fibrosis can cause systemic RV failure in elderly patients with uncomplicated ccTGA despite the absence of severe TR or advanced conduction tissue abnormalities and that CMR may be a useful examination to accurately detect systemic RV failure associated with myocardial fibrosis and to subsequently clarify the prognosis in these patients.

Original languageEnglish
Pages (from-to)151-154
Number of pages4
JournalInternational heart journal
Volume58
Issue number1
DOIs
Publication statusPublished - 2017
Externally publishedYes

Keywords

  • Congenital heart disease
  • Dextrocardia
  • Late gadolinium-enhancement
  • Myocardial fibrosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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