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Clinical Data: After surgical correction of the transposition of the great arteries associated with other defects and heart failure, beginning with termino-terminal coartectomy and pulmonary artery banding at three months (weight = 3800 g) and use of the Jatene technique with the closing off of interventricular communication, and pulmonary banding at ten months (weight = 5200 g), the patient progressed well, recovering weight and remaining symptom-free, despite the appearance of pulmonary artery stenosis at five years of age, improved after dilation by balloon catheter and resulting in a reduction in the pressure gradient, down from 72 mmHg to 26 mmHg. Since then, she has been taking 40 mg/day of propranolol for slight but persistent stenosis of the right ventricular outflow tract. She currently tolerates routine exercises well and does not mention symptoms.  Physical Examination: Good general condition, eupneic, acyanotic, normal pulse. Weight: 73 kg. Height: 156 cm. Right Arm Blood Pressure (RABP) and Right Leg Blood Pressure (RLBP) = 130/80 mm Hg. Heart rate (HR): 73 bpm. The aorta was not palpated and there is a mild systolic murmur at the suprasternal notch.  In the precordium, the ictus cordis was not palpated and there were no systolic impulses. The heart sounds were normophonetic, auscultating a moderate systolic murmur of ++ intensity, harsh, on the upper left sternal edge. The liver was not palpated and the lungs were clear.

Case 4/2013 - Woman with Transposition of the Great Arteries and Delayed Corrective Progress