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Surgery General 009d9f83

A 5 days old, full term male infant was severely cyanotic at bih. PEE was administered initially and later balloon atrial septostomy was done which showed improvement in oxygenation. Most likely diagnosis:

A
Tetralogy of Fallot
B
Transposition of great vessels
C
Truncus aeriosus
D
Tricuspid atresia
High-Yield Explanation
Transposition of great vessels Transposition of great aeries with an intact ventricular septum is also referred to a simple TGA or isolated TGA. * Cyanosis and tachypnea are most often recognized within hours or day one of life, hypoxemia is severe but hea failure is less common. * Transposition of great aeries with VSD - cyanosis can generally recognized within the { 'l month of life, but it may remain diagnosed in some infants for several months. Treatment - Infusion of prostaglandin E2 should be initiated immediately to maintain patency of the ductus aeriosus and improve oxygenation * Infant who remain severely hypoxic or acidotic despite prostaglandin infusion should undergo Rashkind-halloon atrial septostomy Aerial switch (Jantene) procedure is the surgical treatment of choice for neonates with d-TGA and intact ventricular septum and is usually performed within the 1-2 week of life. Truncus Aeriosus (TA) a single aerial trunk :runcus aeriosus) arises from the hea and supplies the systemic pulmonary and coronary circulation. A VSD is always present Clinical picture - In the immediate newborn period, signs of hea failure are usually absent, a murmur and minimal cyanosis are the initial signs. As a conotruneal lesion, T A is often associated with a deletion of chromosome 22q 11 (DiGeorge syndrome) and associated endocrine immunologic, facial and pulmonary abnormalities Treatment - surgery is indicated usually in the 12 weeks of life Older patients -* Hea -lung transplantation is the only options.

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