Transposition of the Great Arteries

What are symptoms of transposition of the great arteries?

Transposition of the great arteries is a rare, critical birth defect in which the two main arteries of the heart (the aorta and the pulmonary artery) are reversed. The switching of the arterial position changes the way blood flows through the heart, resulting in a dangerous shortage of oxygenated blood going to the baby's body. Without an adequate supply of oxygen to the body, serious complications and even death can occur.

The most common symptom of transposition of the great arteries is cyanosis, which is a blue tint to the skin caused by lack of oxygenated blood.

Other signs of transposition of the great arteries include:

• Trouble breathing
• Clubbed feet and toes
• Poor feeding
• Sweating during feeding

Can doctors detect the condition before a baby is born?

Prenatal ultrasound can identify babies with transposition of the great arteries (TGA) early in a mom's pregnancy. Prenatal detection is important because babies with TGA should be delivered at a high-risk center and they will need surgery soon after birth.

How do doctors diagnose transposition of the great arteries after birth?

Transposition of the great arteries in infants is usually diagnosed shortly after birth. Babies with the condition often have a blue tint to their skin, a sign of cyanosis caused by the lack of oxygen-rich blood in the body.

If your doctor suspects your child has TGA, he or she will order further tests. These will help a cardiologist identify the condition and evaluate its severity.

Common tests include:

• Chest X-ray
• EKG
• Echocardiogram (ECHO)
• Diagnostic cardiac catheterization

Treatment for transposition of the great arteries

At Children's Colorado, our pediatric cardiologists and heart surgeons begin treating transposition of the great arteries right after birth.

Transposition of the great arteries treatments include:

Medication

If your child is born with D-type transposition, he or she may require medication and surgery very soon after birth. Most often, children are treated in the intensive care unit with intravenous (IV) medication and oxygen. Sometimes a breathing tube may be necessary for a short time.

If the hole between the atria (atrial septal defect) is not large enough, a minor procedure called an atrial septectomy or Rashkind procedure may be necessary to widen it so oxygen-rich and oxygen-poor blood can mix inside the heart. This is usually performed in the intensive care unit by your child's cardiologist.

Surgery

The only treatment for D-type transposition of the great arteries is heart surgery. The best and most common surgery is the arterial switch procedure, which is performed by pediatric cardiac surgeons. During this surgery, the pulmonary artery and aorta are switched back to their normal positions and the coronary arteries and large blood vessels are also switched. Any holes in the heart will also be repaired.

What are the expected outcomes for children with transposition of the great arteries?

After surgery, most children with transposition of the great arteries go on to live normal, healthy lives, but should be followed by a cardiologist for some time after surgery.

Learn more about pediatric heart surgery at Children's Colorado.