Transposition of the Great Arteries (TGA) Treatment or Arterial Switch Operation
Transposition of the great arteries is a serious but rare heart defect present at birth (congenital), in which the two main arteries leaving the heart are reversed (transposed). The condition is also called dextro-transposition of the great arteries. A rarer type of this condition is called levo-transposition of the great arteries.
Transposition of the great arteries changes the way blood circulates through the body, leaving a shortage of oxygen in blood flowing from the heart to the rest of the body. Without an adequate supply of oxygen-rich blood, the body can't function properly and your child faces serious complications or death without treatment.
Transposition of the great arteries is usually detected either prenatally or within the first hours to weeks of life.
Corrective surgery soon after birth is the usual treatment for transposition of the great arteries. Having a baby with transposition of the great arteries can be alarming, but with proper treatment, the outlook is promising.
Potential complications of transposition of the great arteries include:
- Lack of oxygen to tissues. Your baby's tissues will receive too little oxygen (hypoxia). Unless there's some mixing of oxygen-rich blood and oxygen-poor blood within your baby's body, he or she won't be able to survive.
- Heart failure. Heart failure — a condition in which the heart can't pump enough blood to meet the body's needs — may develop over time because the right ventricle is pumping under higher pressure than usual. This added stress may make the muscle of the right ventricle stiff or weak.
- Lung damage. Too much oxygen-rich blood can cause damage to the lungs, making breathing difficult.
Surgery is required for all babies with transposition of the great arteries early in life, usually within the first week. The most common type of surgery to correct transposition when identified in babies is the arterial switch operation. During this operation, the surgeon moves the great arteries so they are connected to the correct pumping chamber. The arteries that supply the heart (coronary arteries) must also be moved. Although this operation is lifesaving, problems may occur later in life, including:
- Narrowing of the arteries that supply blood to the heart (coronary arteries)
- Heart rhythm abnormalities (arrhythmias)
- Heart muscle weakness or stiffness leading to heart failure
- Narrowed connections where the great vessels are connected
- Leaky heart valves
Although the exact cause of transposition of the great arteries is unknown, several factors may increase the risk of a baby being born with this condition, including:
- A history of German measles (rubella) or another viral illness in the mother during pregnancy
- Drinking alcohol during pregnancy
- Smoking during pregnancy
- A mother who has poorly controlled diabetes