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Transposition of the Great Arteries

Definition of Transposition of the Great Arteries


First medically described by Matthew Baillie during the year 1797, transposition of the great arteries (TGA) is a congenital heart defect, and it affects two vital vessels which carry the blood away from the heart. In this disorder, the two heart vessels, the pulmonary artery and the aorta, are transposed or interchanged. As a result, there is a reversal in the normal pattern of blood flow.

When a person has TGA, the blood circulation changes and becomes abnormal, causing decreased oxygen in the blood. When a person has low supply of oxygen in the blood, he or she will not be able to function properly to the best of his or her abilities. TGA is usually detected during the first few weeks of a person’s life. According to statistics, men are more susceptible to TGA. TGA is characterized by a verticuloarterial discordance.

Transposition of the Great Arteries Symptoms

Infants who are born with TGA will experience the following symptoms:

  • Poor weight gain
  • Lack of appetite
  • Cyanosis or blue coloration of the skin
  • Shortness of breath
  • Clubbing of the toes or fingers
  • Poor feeding problems

Transposition of the Great Arteries Treatment and Surgery

Physicians and health professionals will usually suggest common and effective treatments such as the following:

Pharmacological treatment

When a person has been medically diagnosed with TGA during his or her infant stage, he or she will immediately be given a drug called prostaglandin which is injected intravenously. This drug is known to keep the blood vessel, specifically ductus arteriosus, open and to allow the mixing of oxygenated and unoxygenated blood.

Atrial septostomy

This is a procedure that involves a thin and long flexible tube. In order to for this tube to enter into the defected area, a large hole needs to be created in the area located in the atrial septum to allow the mixture of oxygenated and the unoxygenated blood. This is usually made possible via catheterization of the cardiac system. The mixture of oxygenated and unoxygenated blood, will improve oxygen delivery to the infant’s body. Moreover, there will be an enlarged connection between the upper heart chambers, particularly in the atria region.

Surgical treatment

An infant with TGA requires surgical procedure to correct the defect. The surgical procedure options include the following:

Atrial switch operation

This is a surgical procedure option which corrects the defect. In this surgical procedure, the surgeon will make a tunnel between the left and right atrium which are the two heart chambers located at the upper portion of the heart. The tunnel will redirect unoxygenated blood to the left ventricle and artery of the pulmonary system and oxygenated blood to the right ventricle and the aorta. This procedure allow the right ventricle to pump the right amount of blood so that the body’s blood will be nourished with oxygenated blood.

However, any surgical procedure comes with great risks, in this case, baffled leaks or obstruction, right ventricular problems, and irregular heartbeats.

Arterial switch operation

Arterial switch operation, which is another common and effective surgical procedure, is usually most often performed during the infant’s early months of his or her life.

In this surgical operation, the aorta and pulmonary artery are both moved to their normal position. The aorta is positioned to the left ventricle, while the pulmonary artery is positioned to the right ventricle. Moreover, there is a reattachment of the coronary arteries to the aorta.

The risk factors and outcome for this operation are prematurity and low birth weight of the infant. When an infant has these factors, there will be a higher risk in the morbidity rate of the infant.

If the infant has an atrial or ventricular septal defect, then the holes during the surgical procedure will normally be surgically closed. Most often, the surgeon will not fix the ventricular septal defect, for it has a high ability to close up on its own without any medical surgical intervention.

If a woman who has had surgical repair of TGAp rior to pregnancy, then she may have a high chance of a healthy pregnancy experience. However, there will be a need to receive specialized care if necessary. It is recommended that a woman who intends to get pregnant consult with her obstetrician and cardiologist.

Transposition of the Great Arteries Prognosis and Life Expectancy

Most often infants who have a simple form of TGA will have a good prognosis compared to those who have a complex form of TGA. People who were diagnosed with TGA but who do not manifest or experience any symptoms related to the disease condition are asymptomatic individuals. When a person is asymptomatic, most often he or she does not require surgical intervention. However, if an asymptomatic individual with TGA is not treated, then the disease may lead to fatality within the first few weeks of the person’s life. When a person with TGA has undergone surgical intervention, the survival rate or life expectancy rate will be as high as 90 percent, and most of them will develop and grow normally without any problems. When a person with TGA has anomalies in the cardiac system, the prognosis will be poor and will lead to a high morbidity rate.

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