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Transposition of the great arteries

Transposition of the great arteries: Symptoms, Risk Factors, Diagnosis, Treatments | National Heart Centre Singapore

Transposition of the great arteries - What it is

Transposition of the great arteries (TGA) is a rare heart defect present at birth whereby the two main arteries, Aorta and Pulmonary artery, are reversed. 

This causes a change in blood circulation and oxygen will be unevenly distributed from the heart to the rest of the body.  Due to insufficient oxygen in the blood, one’s body will not be able to function properly, often resulting in serious complications, as such a congenital condition in children will lead to death if left untreated. Transposition of the great arteries is most often detected prenatally or within the first hours to weeks of the child’s life.

Complications to look out for depends on the operation previously performed. 

Possible complications for patients who underwent Mustard or Senning procedure include:
  1. Heart failure
  2. Baffle obstruction / leaks 
  3. Abnormal heart rhythms 
Possible complications for patients post arterial switch include:
  1. Coronary artery disease
  2. Abnormal heart rhythms
  3. Aortic and pulmonary leakage or narrowing (Aortic and pulmonary stenosis/regurgitation)
  4. Aortic dilatation
Possible complications for patients post Rastelli operation include:
  1. Rastelli conduit stenosis or regurgitation
  2. Right heart failure
  3. Abnormal heart rhythms

Transposition of the great arteries - Symptoms

​You will need an earlier visit to your doctor if you develop breathlessness, palpitations (abnormal sensation of the heart beating), lower limb swelling, syncope (fainting), giddiness or chest pain.

Transposition of the great arteries - How to prevent?

Transposition of the great arteries - Causes and Risk Factors

Risk factors

Activity
You may need to restrict your activity especially if your heart function is weak or if there is presence of abnormal heart rhythm. Your cardiologist will determine the limitations to your activities.

Prevention of endocarditis
You will need antibiotics to prevent endocarditis (infection of the inner layer of the heart) before any dental procedures if there are residual problems after operation. Antibiotics may also be required if you should go for body piercing or tattooing. Please consult your cardiologist.

Family planning and pregnancy 
There are some associated risks with pregnancy even after TGA repair is done. Please consult your cardiologist for advice.

Transposition of the great arteries - Diagnosis

Diagnosis usually starts with a physical examination by a doctor, assessing your medical history and routine tests. Other tests recommended may include:

Transposition of the great arteries - Treatments

Corrective surgery will treat the transposition of the great arteries and this treatment can be carried out soon after the child’s birth. While having a baby with this serious condition is alarming, transposition of the great arteries can be alleviated and treated with operation.

Complications after operation should be monitored for and can be treated. Medications (ACE inhibitors and beta blockers) can be useful in heart failure. Abnormal heart rhythms can be managed with medications or ablation procedures. Baffle or conduit stenosis or regurgitation may require intervention with surgery or percutaneous techniques.

Transposition of the great arteries - Preparing for surgery

Transposition of the great arteries - Post-surgery care

Transposition of the great arteries - Other Information

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