Case report of challenges in the management of a rare ductal dependent complex congenital heart disease in a Nigerian tertiary hospital
Keywords:
Congenital heart disease, pulmonary atresia with ventricular septal defect, great vessel anomaly, echocardiographyAbstract
Objective: Complex congenital heart defects are rare and may be difficult to define. They often require early surgery for palliation or correction. A lack of facilities and manpower to provide surgery in developing countries often results in mortality.
Case report: A 6 month old male infant referred to our unit on account of failure to thrive, cyanosis since birth, easy fatigability and breathlessness. On examination he was small for age with tachycardia and a grade III pansystolic murmur at the left lower sternal edge. Chest radiograph revealed an “egg on side” cardiac appearance with cardiomegaly. Echocardiography confirmed the presence of d-transposition of the great arteries with a patent foramen ovale, large ventricular septal defect and atresia of the proximal main pulmonary artery. The child died while being prepared for referral to a centre for palliative surgery.
Conclusion: Transposition of the great arteries with pulmonary atresia is an uncommon congenital heart disease. Early intervention with palliative surgery is necessary to prevent mortality.
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