AboutKidsHealth

 

 

Transposition of the great arteries (TGA)TTransposition of the great arteries (TGA)Transposition of the great arteries (TGA)EnglishCardiologyChild (0-12 years)HeartCardiovascular systemConditions and diseasesAdult (19+)NA2023-03-24T04:00:00Z10.100000000000052.00000000000001256.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Transposition of the great arteries (TGA) is a condition where the arteries connected to the heart are improperly positioned. Learn about the diagnosis, treatment and what children with a repaired TGA can expect in the future.</p><h2>What is transposition of the great arteries (TGA)?</h2><p>Complete transposition of the great arteries (TGA) is a rare congenital heart defect. Congenital means present at birth. It is a common reason for a newborn to have heart surgery. </p><p>In a standard heart, the blood low in oxygen comes from the body back to the heart’s right side and is pumped through the pulmonary artery to the lungs where it "reloads" oxygen and goes to the left side of the heart to be sent to the body through the aorta. This way oxygen is distributed to the whole body.</p> <figure class="asset-c-80"> <span class="asset-image-title">Normal </span> <span class="asset-image-title">heart</span><img src="https://assets.aboutkidshealth.ca/akhassets/Hearts_CHD/Normal_Heart_CHD.jpg" alt="Normal heart showing placement of the atria, ventricles, aorta, superior vena cava, inferior vena cava, pulmonary artery and pulmonary veins" /><figcaption class="asset-image-caption">The</figcaption><figcaption class="asset-image-caption"> heart has two upper (receiving) and two lower (pumping) chambers. Blood flows into the upper chambers (the right atrium and the left atrium). The lower chambers (the right and left ventricles) pump blood out of the heart. The heart valves open and close to keep blood flowing in the correct direction. </figcaption> </figure> <p>In people born with TGA, the two main arteries (the great arteries) that are connected to the heart are switched, or transposed.</p><ul><li>The aorta is connected to the heart’s right ventricle instead of the left ventricle.</li><li>The pulmonary artery is connected to the left ventricle instead of the right ventricle. </li></ul> <figure class="asset-c-80"> <span class="asset-image-title">Transposition of the great arteries (TGA)</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/Hearts_CHD/TGA_Newborn.jpg" alt="Heart showing aorta and pulmonary artery are switched, aorta pumps blood low in oxygen to body, pulmonary arter pumps blood high in oxygen to lungs, left ventricle connected to pulmonary artery, right ventricle connected to aorta." /><figcaption class="asset-image-caption">The main arteries that carry blood to the body and lungs are reversed in babies born with transposition of the great arteries. Blood high in oxygen is pumped to the lungs instead of the body and blood low in oxygen is pumped to the body, without passing through the lungs. </figcaption> </figure> <p>This switch of the great arteries means that blood that is low in oxygen gets pumped around the body instead of blood that is high in oxygen. An open-heart surgery called the arterial switch operation is needed to fix this problem with the heart's arteries. </p><p>Some patients with TGA may also have other heart problems, such as a <a href="/article?contentid=1626&language=english">ventricular septal defect (VSD)</a>, abnormal coronary arteries (blood vessels that carry blood and oxygen into the heart muscle) or <a href="/article?contentid=1619&language=english">pulmonary stenosis</a>. </p><h2>Key points</h2><ul><li>In people with transposition of the great arteries (TGA) the two main arteries connected to the heart are switched.</li><li>The aorta is connected to the heart’s right ventricle instead of the left ventricle. The pulmonary artery is connected to the left ventricle instead of the right ventricle. </li><li>An operation called an "arterial switch" is needed to correct this.</li><li>People who have TGA have a normal life expectancy, however some complications can develop. </li></ul><h2>How is TGA diagnosed?</h2><p>TGA can sometimes be detected during pregnancy before a baby is born by routine ultrasound. After birth, if a baby appears blue (cyanotic) and has low oxygen saturations, TGA is suspected. An echocardiogram is done to confirm the diagnosis. Commonly, a chest X-ray and ECG are also performed.</p><h2>How is TGA treated?</h2><h3>Before the surgery</h3><p>Before having the arterial switch operation, most babies born with TGA need to be stabilised by increasing the amount of oxygen rich blood that gets to the body before they are ready for the arterial switch operation. This can be done using a medication called prostaglandin and an interventional procedure performed at the bedside called a balloon atrial septostomy. </p><p>Prostaglandin given through the vein keeps the arterial duct (PDA) open, which allows blood to mix. This results in more oxygen rich blood getting to the body's organs. This medication can sometimes interfere with a baby's breathing. A ventilator is used to help with the breathing. </p><h3>Balloon atrial septostomy</h3><p>For most babies, a balloon atrial septostomy is also required to increase oxygen to the baby’s body. This is a procedure performed at the bedside. It involves putting a catheter (small tube) into a vein in the baby’s leg and passing the catheter into the heart and across the atrial septum (the wall that divides the two upper chambers, or atria, of the heart). A balloon at the end of the catheter is inflated and pulled back across the septum to make a hole. </p><p>This hole in the atrial septum allows blood that is high in oxygen in the left atrium to mix with blood that is low in oxygen in the right atrium. The result is that blood higher in oxygen is pumped to the body via the aorta. The hole that is created is fixed at the time of the arterial switch. A balloon atrial septostomy is generally very safe. Prostaglandin can sometimes be stopped after the balloon atrial septostomy. </p><p>To read more about this procedure, please see the page <a href="/article?contentid=1668&language=english">Balloon atrial septostomy</a>.</p><h3>The arterial switch operation</h3><p>Usually, the arterial switch operation takes place within the first two weeks after being born. If there is a VSD, sometimes this can be delayed to about six weeks old. </p><p>The arterial switch operation switches or swaps the great arteries back to their normal position, so that the aorta is connected to the left ventricle and the pulmonary artery to the right ventricle. In addition to swapping the great arteries, the coronary arteries are attached to the new aorta in the correct position. If there is a VSD then that is closed as well. </p><p>To read more about this procedure, please see the page <a href="/article?contentid=1656&language=english">Arterial switch procedure</a>.</p><h2>Complications of the arterial switch</h2><p>Although the arterial switch is major heart surgery, it is a very successful operation. However, some complications can occur. TGA is a lifelong condition and therefore it is important to keep seeing a cardiologist as many complications can be detected before symptoms develop. </p><h3>Pulmonary artery and branch pulmonary artery narrowing</h3><p>In a small number of children, the main pulmonary artery or the branch pulmonary arteries may become narrow. Sometimes an intervention called a balloon dilation is needed to enlarge the narrowed section and, rarely, a stent ( small metal tube) is required to widen the narrowed section by supporting the walls of the blood vessel or conduit to keep it open. If this is not successful, another operation may be required. </p><h3>Coronary artery problems</h3><p>Much more rarely, a problem with a coronary artery, which was moved at the time of the arterial switch operation, may develop. A CT scan or cardiac catheterization may be needed to diagnose this problem.</p><h3>Dilation of the aorta and leaky aortic valve</h3><p>Sometimes the aorta can dilate (become larger) at the site where it was reattached to the left ventricle, this can be diagnosed by regular follow up with a cardiologist. Similarly, a leaky aortic valve can be diagnosed before symptoms develop.</p>
Transposition complète des gros vaisseauxTTransposition complète des gros vaisseauxComplete Transposition of the Great Arteries (TGA)FrenchCardiologyChild (0-12 years)HeartCardiovascular systemConditions and diseasesAdult (19+)NA2009-12-04T05:00:00Z11.000000000000047.0000000000000542.000000000000Flat ContentHealth A-ZInformez-vous sur la transposition complète des gros vaisseaux. Cette anomalie fait en sorte que les vaisseaux qui transportent le sang depuis le cœur sont mal disposés.<p>Cette anomalie fait en sorte que la position des vaisseaux qui amènent le sang du cœur aux poumons et au corps est interversée : l’aorte sort du ventricule droit et l’artère pulmonaire sort du ventricule gauche. Cela signifie que le sang qui renferme déjà de l’oxygène se rend aux poumons, et que le sang qui a besoin d’oxygène circule dans le corps. </p><h2> À retenir </h2> <ul><li> La transposition complète des gros vaisseaux fait en sorte que le sang qui a besoin d’oxygène circule dans le corps au lieu des poumons. </li> <li>Cette anomalie est fatale à moins qu’il existe une autre anomalie qui permet au sang de se mélanger entre deux systèmes circulatoires pour que le corps reçoive l’oxygène dont il a besoin. </li> <li>Les bébés nés avec une transposition complète des gros vaisseaux montrent des symptômes, habituellement la cyanose, immédiatement après la naissance. </li> <li>Ces bébés devront subir une chirurgie à coeur ouvert dans les premières semaines suivant la naissance. </li></ul>

 

 

 

 

Transposition of the great arteries (TGA)1611.00000000000Transposition of the great arteries (TGA)Transposition of the great arteries (TGA)TEnglishCardiologyChild (0-12 years)HeartCardiovascular systemConditions and diseasesAdult (19+)NA2023-03-24T04:00:00Z10.100000000000052.00000000000001256.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Transposition of the great arteries (TGA) is a condition where the arteries connected to the heart are improperly positioned. Learn about the diagnosis, treatment and what children with a repaired TGA can expect in the future.</p><h2>What is transposition of the great arteries (TGA)?</h2><p>Complete transposition of the great arteries (TGA) is a rare congenital heart defect. Congenital means present at birth. It is a common reason for a newborn to have heart surgery. </p><p>In a standard heart, the blood low in oxygen comes from the body back to the heart’s right side and is pumped through the pulmonary artery to the lungs where it "reloads" oxygen and goes to the left side of the heart to be sent to the body through the aorta. This way oxygen is distributed to the whole body.</p> <figure class="asset-c-80"> <span class="asset-image-title">Normal </span> <span class="asset-image-title">heart</span><img src="https://assets.aboutkidshealth.ca/akhassets/Hearts_CHD/Normal_Heart_CHD.jpg" alt="Normal heart showing placement of the atria, ventricles, aorta, superior vena cava, inferior vena cava, pulmonary artery and pulmonary veins" /><figcaption class="asset-image-caption">The</figcaption><figcaption class="asset-image-caption"> heart has two upper (receiving) and two lower (pumping) chambers. Blood flows into the upper chambers (the right atrium and the left atrium). The lower chambers (the right and left ventricles) pump blood out of the heart. The heart valves open and close to keep blood flowing in the correct direction. </figcaption> </figure> <p>In people born with TGA, the two main arteries (the great arteries) that are connected to the heart are switched, or transposed.</p><ul><li>The aorta is connected to the heart’s right ventricle instead of the left ventricle.</li><li>The pulmonary artery is connected to the left ventricle instead of the right ventricle. </li></ul> <figure class="asset-c-80"> <span class="asset-image-title">Transposition of the great arteries (TGA)</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/Hearts_CHD/TGA_Newborn.jpg" alt="Heart showing aorta and pulmonary artery are switched, aorta pumps blood low in oxygen to body, pulmonary arter pumps blood high in oxygen to lungs, left ventricle connected to pulmonary artery, right ventricle connected to aorta." /><figcaption class="asset-image-caption">The main arteries that carry blood to the body and lungs are reversed in babies born with transposition of the great arteries. Blood high in oxygen is pumped to the lungs instead of the body and blood low in oxygen is pumped to the body, without passing through the lungs. </figcaption> </figure> <p>This switch of the great arteries means that blood that is low in oxygen gets pumped around the body instead of blood that is high in oxygen. An open-heart surgery called the arterial switch operation is needed to fix this problem with the heart's arteries. </p><p>Some patients with TGA may also have other heart problems, such as a <a href="/article?contentid=1626&language=english">ventricular septal defect (VSD)</a>, abnormal coronary arteries (blood vessels that carry blood and oxygen into the heart muscle) or <a href="/article?contentid=1619&language=english">pulmonary stenosis</a>. </p><h2>Key points</h2><ul><li>In people with transposition of the great arteries (TGA) the two main arteries connected to the heart are switched.</li><li>The aorta is connected to the heart’s right ventricle instead of the left ventricle. The pulmonary artery is connected to the left ventricle instead of the right ventricle. </li><li>An operation called an "arterial switch" is needed to correct this.</li><li>People who have TGA have a normal life expectancy, however some complications can develop. </li></ul><h2>How is TGA diagnosed?</h2><p>TGA can sometimes be detected during pregnancy before a baby is born by routine ultrasound. After birth, if a baby appears blue (cyanotic) and has low oxygen saturations, TGA is suspected. An echocardiogram is done to confirm the diagnosis. Commonly, a chest X-ray and ECG are also performed.</p><h2>How is TGA treated?</h2><h3>Before the surgery</h3><p>Before having the arterial switch operation, most babies born with TGA need to be stabilised by increasing the amount of oxygen rich blood that gets to the body before they are ready for the arterial switch operation. This can be done using a medication called prostaglandin and an interventional procedure performed at the bedside called a balloon atrial septostomy. </p><p>Prostaglandin given through the vein keeps the arterial duct (PDA) open, which allows blood to mix. This results in more oxygen rich blood getting to the body's organs. This medication can sometimes interfere with a baby's breathing. A ventilator is used to help with the breathing. </p><h3>Balloon atrial septostomy</h3><p>For most babies, a balloon atrial septostomy is also required to increase oxygen to the baby’s body. This is a procedure performed at the bedside. It involves putting a catheter (small tube) into a vein in the baby’s leg and passing the catheter into the heart and across the atrial septum (the wall that divides the two upper chambers, or atria, of the heart). A balloon at the end of the catheter is inflated and pulled back across the septum to make a hole. </p><p>This hole in the atrial septum allows blood that is high in oxygen in the left atrium to mix with blood that is low in oxygen in the right atrium. The result is that blood higher in oxygen is pumped to the body via the aorta. The hole that is created is fixed at the time of the arterial switch. A balloon atrial septostomy is generally very safe. Prostaglandin can sometimes be stopped after the balloon atrial septostomy. </p><p>To read more about this procedure, please see the page <a href="/article?contentid=1668&language=english">Balloon atrial septostomy</a>.</p><h3>The arterial switch operation</h3><p>Usually, the arterial switch operation takes place within the first two weeks after being born. If there is a VSD, sometimes this can be delayed to about six weeks old. </p><p>The arterial switch operation switches or swaps the great arteries back to their normal position, so that the aorta is connected to the left ventricle and the pulmonary artery to the right ventricle. In addition to swapping the great arteries, the coronary arteries are attached to the new aorta in the correct position. If there is a VSD then that is closed as well. </p><p>To read more about this procedure, please see the page <a href="/article?contentid=1656&language=english">Arterial switch procedure</a>.</p><h2>Complications of the arterial switch</h2><p>Although the arterial switch is major heart surgery, it is a very successful operation. However, some complications can occur. TGA is a lifelong condition and therefore it is important to keep seeing a cardiologist as many complications can be detected before symptoms develop. </p><h3>Pulmonary artery and branch pulmonary artery narrowing</h3><p>In a small number of children, the main pulmonary artery or the branch pulmonary arteries may become narrow. Sometimes an intervention called a balloon dilation is needed to enlarge the narrowed section and, rarely, a stent ( small metal tube) is required to widen the narrowed section by supporting the walls of the blood vessel or conduit to keep it open. If this is not successful, another operation may be required. </p><h3>Coronary artery problems</h3><p>Much more rarely, a problem with a coronary artery, which was moved at the time of the arterial switch operation, may develop. A CT scan or cardiac catheterization may be needed to diagnose this problem.</p><h3>Dilation of the aorta and leaky aortic valve</h3><p>Sometimes the aorta can dilate (become larger) at the site where it was reattached to the left ventricle, this can be diagnosed by regular follow up with a cardiologist. Similarly, a leaky aortic valve can be diagnosed before symptoms develop.</p><h2>What is the long-term outlook for children with repaired TGA?</h2><h3>Can patients with a repaired TGA exercise normally?</h3><p>Children who had surgery for TGA are expected to grow and be able to exercise normally. In the past patients with congenital heart disease were often told not to exercise, or to push too hard during exercise as the heart was weak. However, this is not true and regular exercise is beneficial. People with repaired TGA can usually participate in all sporting activities without restrictions. If this is not the case, your cardiologist will let you know.</p><h3>Family history and CHD</h3><p>The risk for any person having a baby with congenital heart disease is about 1%. Babies born to a parent who has congenital heart disease, such as an TGA, the chance that the baby will have any type of congenital heart disease is about 3% . This risk is for both men and women. That still means there is a 97% chance that the baby will not have congenital heart disease. </p><p>Women with congenital heart disease can talk with a genetic counselor or genetic specialist before becoming pregnant. A special ultrasound scan of the fetus’ heart can be performed during the pregnancy to look for congenital heart disease. </p>Transposition of the great arteries (TGA)False

Thank you to our sponsors

AboutKidsHealth is proud to partner with the following sponsors as they support our mission to improve the health and wellbeing of children in Canada and around the world by making accessible health care information available via the internet.

Our Sponsors