Transposition of the Great Arteries (TGA)

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Transposition of the Great Arteries (TGA)

Types :

• Complete
• With Communication
• Corrected

1. Complete : has 2 circuits 

• Oxygenated - Pulmonary circuit
• Un-Oxygenated - Systemic circuit

Therefore O2 therapy will not help as there is no path for O2 to reach systemic circuit.

Hence the child dies without t/t in 1st wk of life due to Hypoxia

T/t - 

• PGE1 infusion to keep Ductus open (i.e to keep PDA)

• Emergency Surgery ( Create artificial ASD with balloon - Balloon atrial septostomy )

Definitive Surgery at later stage : Arterial Switch Surgery ( Jatene Procedure )


2. With Communication : 

• With ASD - Small patent foramen ovale , Not helpful - hence cyanosis in 1st wk of life

• With VSD and PDA - good mixing of blood , therefore only mild cyanosis at 6-12 months of life.

3. Corrected : Physiologically behaves Normal.

Ventriculo-Arterial disconcordance with Atrioventricular disconcordance (See the image below)

• Ventriculo-Arterial disconcordance means - Aorta arise from RV ; PA arise from LV
• AtrioVentricular dysconcordance means - Rt Arium opens into LV ; Lt Atrium opens into RV

Image Courtesy - DrAyushGoel

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MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel