Transposition of the Great Arteries

What is transposition of the great arteries?

Transposition of the great arteries (TGA) is a complex heart condition that affects how blood moves through a baby’s heart. It’s a type of congenital heart condition, which means it’s a condition a baby is born with.

The great arteries are the aorta and the pulmonary artery. Normally, the aorta is connected to the left ventricle and pumps out blood to the body. The pulmonary artery is normally connected to the right ventricle and pumps blood to the lungs for oxygen. These two arteries in a baby with TGA are connected to the opposite ventricle. This means that blood without enough oxygen is being sent to the body while blood with oxygen is sent back to the lungs.

Some babies with TGA also have other heart defects, such as holes between the upper or lower chambers of the heart. These holes may allow more blood with oxygen to get out to the baby’s body, but it is not enough oxygen to survive without surgery.

What are the signs and symptoms of transposition of the great arteries?

In some cases, transposition of the great arteries is found before birth during an ultrasound or fetal echocardiogram.

When a baby is born with TGA, they usually have symptoms shortly after birth. Symptoms may include:

• A blue tint to the skin (cyanosis)
• Fast breathing
• Trouble breathing
• Poor feeding

What causes TGA?

Experts do know what causes TGA. The condition develops early in pregnancy when the heart is formed.

How is TGA treated?

The treatment for TGA may depend on your baby’s specific heart anatomy. Most babies with TGA need some type of treatment to improve their oxygen levels shortly after birth. Your care team at Arkansas Children’s is experienced in treating TGA and will work with you to develop the best treatment plan for your child. Treatment options may include:

• Medication to keep a connection in the heart, called the ductus arteriosus, open after birth. Usually it closes shortly after birth, but if kept open, it can help deliver blood to the lungs until your baby can have a permanent treatment.
• A catheterization procedure, called a balloon atrial septostomy is often done shortly after birth. This procedure uses a thin tube (called a catheter) with a balloon on the end of it to enlarge a hole (foramen ovale) in the heart that usually closes after birth. This hole allow some oxygen-rich blood to get out to the body.
• Surgery to repair the condition, called the arterial switch, is the only permanent treatment for babies with TGA. The surgery repairs the heart so the pulmonary artery is attached to the right ventricle and the aorta is attached to the left ventricle.

After surgery, babies with TGA will need to have follow-up visits with a cardiologist (a heart doctor) into adulthood. As they grow, some children may need additional treatments or surgeries.