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
Answer is B. 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.