Learn About Transposition of the Great Arteries

What is the definition of 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).

What are the alternative names for Transposition of the Great Arteries?

d-TGA; Congenital heart defect - transposition; Cyanotic heart disease - transposition; Birth defect - transposition; Transposition of the great vessels; TGV

What are the causes of Transposition of the Great Arteries?

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.

What are the symptoms of Transposition of the Great Arteries?

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
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What are the current treatments for Transposition of the Great Arteries?

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.

Who are the top Transposition of the Great Arteries Local Doctors?
Pediatric Cardiology | Pediatrics | Cardiology
Pediatric Cardiology | Pediatrics | Cardiology
20 York St, Ynhh (children's) West Pavilion 2nd Floor, 
New Haven, CT 
 5.0 mi

John Fahey is a Pediatric Cardiologist and a Pediatrics provider in New Haven, Connecticut. Dr. Fahey and is rated as an Advanced provider 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, Double Inlet Left Ventricle, and Endocardial Cushion Defect.

Pediatric Cardiology | Cardiology | Pediatrics
Pediatric Cardiology | Cardiology | Pediatrics
1 Park Street, 
New Haven, CT 
 5.0 mi

Britton Keeshan is a Pediatric Cardiologist and a Cardiologist in New Haven, Connecticut. Dr. Keeshan and is rated as an Experienced provider by MediFind in the treatment of Transposition of the Great Arteries. His top areas of expertise are Congenital Heart Disease (CHD), Double Discordia, Patent Foramen Ovale, Atrial Septal Defect (ASD), and Heart Transplant.

 
 
 
 
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Pediatric Cardiology | Cardiology | Pediatrics
Pediatric Cardiology | Cardiology | Pediatrics

Yale University

20 York St, 
New Haven, CT 
 5.0 mi

Robert Elder is a Pediatric Cardiologist and a Cardiologist in New Haven, Connecticut. Dr. Elder and is rated as an Experienced provider by MediFind in the treatment of Transposition of the Great Arteries. His top areas of expertise are Ventricular Septal Defects, Congenital Heart Disease (CHD), Williams Syndrome, Thymectomy, and Heart Transplant.

What is the outlook (prognosis) for Transposition of the Great Arteries?

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.

What are the possible complications of Transposition of the Great Arteries?

Complications may include:

  • Coronary artery problems
  • Heart valve problems
  • Irregular heart rhythms (arrhythmias)
When should I contact a medical professional for Transposition of the Great Arteries?

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.

How do I prevent Transposition of the Great Arteries?

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.
What are the latest Transposition of the Great Arteries Clinical Trials?
MASA Valve Early Feasibility Study

Summary: The MASA Valve Early Feasibility Study (MVEFS) multi-site interventional clinical trial within the United States of America with each center following a common protocol.The objective of the trial is to evaluate the safety and probable benefit of MASA Valve in the indicated subset of patients requiring Right Ventricular Outflow Tract Reconstruction (RVOTR). As an early feasibility study, the purpos...

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Mechanistic Clinical Trial of Beta-Blocker Administration For Reactivating Cardiomyocyte Division In Tetralogy of Fallot

Summary: Heart failure is a common long-term complication in patients with congenital heart disease (CHD). Medical treatments to promote regeneration of new healthy heart muscle cells have the potential to provide new heart failure treatments for these patients. The development of such therapies is limited by the poor understanding of the ways in which heart muscles grow after birth. Investigators have lea...

Who are the sources who wrote this article ?

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.

What are the references for this article ?

Bernstein D. Cyanotic congenital heart disease: evaluation of the critically ill neonate with cyanosis and respiratory distress. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 456.

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.