Learn About Transposition of the Great Arteries
Transposition of the great arteries (TGA) is a heart defect that occurs from birth (congenital). The two major arteries that carry blood away from the heart -- the aorta and the pulmonary artery -- are switched (transposed).
d-TGA; Congenital heart defect - transposition; Cyanotic heart disease - transposition; Birth defect - transposition; Transposition of the great vessels; TGV
The cause of TGA is unknown. It is not associated with any one common genetic abnormality. It rarely occurs in other family members.
TGA is a cyanotic heart defect. This means there is decreased oxygen in the blood that is pumped from the heart to the rest of the body.
In normal hearts, blood that returns from the body goes through the right side of the heart and pulmonary artery to the lungs to get oxygen. The blood then comes back to the left side of the heart and travels out the aorta to the body.
In TGA, venous blood returns normally to the heart through the right atrium. But, instead of going to the lungs to absorb oxygen, this blood is pumped out through the aorta and back to the body. This blood has not been recharged with oxygen and leads to cyanosis, a bluish discoloration of the skin and mucous membranes.
Symptoms appear at birth or very soon afterward. How bad the symptoms are depends on the type and size of additional heart defects (such as atrial septal defect, ventricular septal defect, or patent ductus arteriosus) and how much the blood can mix between the two abnormal circulations.
Symptoms may include:
- Bluish color to the skin (cyanosis) due to low oxygen level in the blood
- Clubbing of the fingers or toes
- Poor feeding
- Shortness of breath
The initial step in treatment is to allow oxygen-rich blood to mix with poorly oxygenated blood. The baby will immediately receive a medicine called prostaglandin through an IV (intravenous line). This medicine helps keep a blood vessel called the ductus arteriosus open, allowing some mixing of the two blood circulations. In some cases, an opening between the right and left atrium can be created with procedure using a balloon catheter. This allows blood to mix. This procedure is known as balloon atrial septostomy.
Permanent treatment involves heart surgery during which the great arteries are cut and stitched back to their correct position. This is called an arterial switch operation (ASO). Prior to the development of this surgery, a surgery called an atrial switch (or Mustard procedure or Senning procedure) was used.
Roxy Senior practices in London, United Kingdom. Mr. Senior is rated as an Elite expert by MediFind in the treatment of Transposition of the Great Arteries. His top areas of expertise are Transposition of the Great Arteries, Angina, Coronary Heart Disease, Heart Transplant, and Percutaneous Coronary Intervention (PCI).
Atrium Health Levine Children's HEARTest Yard Congenital Heart Center
Jorge Alegria is a Cardiologist in Charlotte, North Carolina. Dr. Alegria is rated as a Distinguished provider by MediFind in the treatment of Transposition of the Great Arteries. His top areas of expertise are Transposition of the Great Arteries, Tetralogy of Fallot, Situs Inversus, and Dextrocardia with Situs Inversus. Dr. Alegria is currently accepting new patients.
Damien Bonnet practices in Paris, France. Mr. Bonnet is rated as an Elite expert by MediFind in the treatment of Transposition of the Great Arteries. His top areas of expertise are Transposition of the Great Arteries, Ventricular Septal Defects, Pulmonary Hypertension, Lung Transplant, and Heart Transplant.
The child's symptoms will improve after surgery to correct the defect. Most infants who undergo arterial switch do not have symptoms after surgery and live normal lives. If corrective surgery is not performed, the life expectancy is only months.
Complications may include:
- Coronary artery problems
- Heart valve problems
- Irregular heart rhythms (arrhythmias)
This condition can be diagnosed before birth using a fetal echocardiogram. If not, it is most often diagnosed soon after a baby is born.
Go to the emergency room or call the local emergency number (such as 911) if your baby's skin develops a bluish color, especially in the face or trunk.
Contact your provider if your baby has this condition and new symptoms develop, get worse, or continue after treatment.
Women who plan to become pregnant should be immunized against rubella if they are not already immune. Rubella infection in a pregnant woman can cause CHD.
Women who are pregnant should get good prenatal care:
- Avoid alcohol and illegal drugs during pregnancy.
- Tell your provider that you are pregnant before taking any new medicines.
- Have a blood test early in your pregnancy to see if you are immune to rubella. If you are not immune, avoid any possible exposure to rubella and get vaccinated right after delivery.
- Pregnant women who have diabetes should try to get good control over their blood sugar level.
Summary: Child health serves as the foundation for overall public health, with neonatal mortality recognized globally as a comprehensive indicator of national health standards and societal advancement. The Healthy Children Action Improvement Plan (2021-2025) sets a national target to reduce neonatal mortality in China to below 3.1‰. Congenital heart disease (CHD), the most prevalent congenital defect among...
Summary: Children living with chronic health conditions face a higher risk of developing cardiovascular diseases than their peers, largely due to the accelerated aging of the heart and blood vessels. Although experts recognize this elevated risk and recommend close monitoring and early intervention, the underlying mechanisms driving this phenomenon remain poorly understood. At present, no effective interve...
Published Date: October 23, 2023
Published By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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Valente AM, Dorfman AL, Babu-Narayan SV, Kreiger EV. Congenital heart disease in the adolescent and adult. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 82.
Well A, Fraser CD. Congenital heart disease. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 59.