What is TGA?

Transposition of the great arteries is a rare congenital heart defect involving an abnormal arrangement of the aorta and the pulmonary arteries (the two major arteries carrying blood away from the heart). The aorta rises from the right ventricle instead of the left, and the pulmonary artery rises from the left ventricle instead of the right. This condition is recognized early, often at birth. Transposition of the great arteries should be treated promptly to avoid complications. Even with treatment, patients diagnosed with this condition remain at risk for complications throughout adulthood. Therefore, regular lifelong care by a cardiologist who specializes in congenital heart conditions is important.

Transposition of the great arteries causes

Transposition of the great arteries occurs during fetal development. In most cases, the cause is unknown.

Risk factors may include:

• Poor maternal nutrition
• Older maternal age
• Maternal alcoholism
• Maternal diabetes
• A parent with the condition or another congenital heart defect

If your family has a history of congenital heart defects, you may want to consider consulting with a genetic counselor, who may recommend genetic testing.

TGA symptoms

The primary symptom is cyanosis (bluish coloration of the skin due to low oxygen levels in the blood). Infants who display this symptom are sometimes referred to as blue babies. In addition to cyanosis, symptoms include shortness of breath, lack of appetite and failure to gain weight.

Diagnosis of TGA

At Ohio State, we ensure that each patient receives individualized care for their congenital heart defect. By creating a care team to diagnose and treat each case, we can better understand what steps will help patients get back to living their lives.

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How Ohio State treats transposition of the great arteries

Babies born with transposition of the great arteries must have surgery to correct the heart defect.

Medications

If surgery is not immediately possible, medications can help to manage the condition until surgery occurs. Prostaglandins, a medication to dilate the blood vessels, may be recommended before a baby is ready for surgery.

Nonsurgical procedures

A cardiac catheterization procedure can enlarge the connection between the heart’s upper chambers and improve oxygen delivery throughout the body until surgery is possible.

Transposition of the great arteries surgery

Surgical procedures to treat transposition of the great arteries include:

• Arterial switch operation: This procedure, usually performed in the first month of life, is the most common surgery to treat the condition. In this procedure, the pulmonary artery and the aorta are moved into their proper positions.
• Atrial switch operation: This procedure creates a tunnel between the two upper chambers of the heart and redirects the blood flowing through the heart so that blood carrying oxygen from the lungs is pumped out to the body blockage and other abnormalities.