Transarterial approach of the pulmonary artery in anatomically corrected malposition of the great arteries by manipulating a catheter inverted with balloon floating maneuver

Int J Cardiol. 1998 Nov 30;67(1):1-7. doi: 10.1016/s0167-5273(98)00247-2.


We describe two neonates with anatomically corrected malposition of the great arteries (ACM). A 1-day-old female newborn, who had the salient clinical findings of Goldenhar syndrome, behaved like a patient with the tetralogy of Fallot. The cardiac malformations included ACM, perimembranous inlet and outlet ventricular septal defect with tricuspid valve straddling, conoventricular septal malaligement, bilateral cori without aortic-mitral continuity, pulmonary stenosis at subvalvular, valvular, and supravalvular levels, and bicuspid semilunar valves. After the procedure of left Blalock-Taussig shunt at 3 months of age, cyanosis was alleviated. The other 1-month-old male newborn, who presented with prolonged feeding, tachypnea and tachycardia, likened to a patient with the hypoplastic left heart syndrome. He had a combination of ACM, mitral stenosis, hypoplastic left atrium and left ventricle, a restrictive patent foramen ovale, ventricular septal defect, subaortic conus without aortic-mitral continuity, subaortic stenosis, and a narrow ascending aortic root. Rashkind balloon atrioseptostomy was done with limited success. He survived a Norwood procedure. Transarterial entry of the catheter, which was inverted with the aid of balloon floating maneuver, to hook the retro-aortic pulmonary artery in ACM is recommended.

Publication types

  • Case Reports

MeSH terms

  • Angiography
  • Cardiac Catheterization / instrumentation
  • Cardiac Catheterization / methods*
  • Echocardiography
  • Female
  • Goldenhar Syndrome / complications
  • Heart / diagnostic imaging
  • Heart Defects, Congenital / complications
  • Humans
  • Infant, Newborn
  • Male
  • Pulmonary Artery*
  • Transposition of Great Vessels / complications
  • Transposition of Great Vessels / diagnosis*