Prenatal diagnosis of congenitally corrected transposition of the great arteries; case report and a compressive review

INTRODUCTION: Congenitally corrected transposition of the great arteries represents a complex anomaly within the spectrum of structural heart diseases, representing less than 1% of congenital heart diseases. This condition is characterized by anatomical abnormalities that result in a double discordance, affecting both the atrioventricular and ventriculoarterial connection. Despite the malformations, normal blood flow is maintained, which gives the name: "congenitally corrected". CLINICAL CASE: 25-year-old primigravida, with no relevant history, referred to maternal-fetal medicine due to 32.2-week pregnancy and suspected congenital heart disease. Assessment in maternal fetal medicine reveals a normal disposition of the heart. Four-chamber section with atrial cavities of adequate dimensions and atrioventricular discordance is detected. She had a vaginal delivery without complications at 39.5 weeks of gestation. A male newborn is evaluated by pediatric cardiology, who, using transthoracic ultrasound, confirm the diagnosis. At 7 months of age, the infant is asymptomatic and continues to be monitored by pediatric cardiology. CONCLUSIONS: Prenatal diagnosis remains a challenge in standard evaluation. Prenatal diagnosis of congenitally corrected transposition of the great arteries is based on the identification of double discordances, atrioventricular and ventriculoarterial, associated with the abnormal arrangement of the great vessels with a parallel course. The ultrasound marker most associated with the diagnosis is the presence of the moderator band on the left side of the heart. Although prenatal diagnosis does not entail specific interventions to improve prognosis, it facilitates the necessary care and follow-up in identified patients.