Transposition of great vessels

Transposition of the Great Vessels
Specialty	Cardiology, Pediatric cardiology
Symptoms	Cyanosis, difficulty breathing, poor feeding
Usual onset	Birth
Duration	Long-term
Types	d-TGA, l-TGA
Causes	Unknown
Risk factors	Genetic factors, environmental factors
Diagnostic method	Echocardiography, Cardiac catheterization
Treatment	Arterial switch operation, Balloon atrial septostomy
Prognosis	Varies with treatment

Transposition of the great vessels (TGV) is a congenital heart defect in which the two major vessels that carry blood away from the heart – the aorta and the pulmonary artery – are switched (transposed). This condition is specifically known as dextro-transposition of the great arteries (d-TGA) when the aorta arises from the right ventricle and the pulmonary artery from the left ventricle. Another less common form is levo-transposition of the great arteries (l-TGA), where the ventricles are also inverted.

Symptoms and Diagnosis

Infants with TGV often show signs of cyanosis (a bluish tint to the skin, lips, and fingernails), difficulty breathing, and poor feeding. Diagnosis is typically made using echocardiography, which can visualize the abnormal connections, and confirmed with cardiac catheterization.

Causes and Risk Factors

The exact causes of TGV are not well understood, but it is believed to involve a combination of genetic and environmental factors. There is no known method for preventing the condition.

Treatment

Treatment for TGV generally involves surgical intervention to correct the abnormality. The most common procedure is the arterial switch operation, which is usually performed within the first few weeks of life. This surgery involves re-establishing the correct connections of the aorta and the pulmonary artery to the appropriate ventricles. Another procedure, balloon atrial septostomy, may be performed to improve oxygenation before more definitive surgery can be undertaken.

Prognosis

The prognosis for infants with TGV has improved significantly with advances in surgical techniques. Most children who undergo the arterial switch operation can lead relatively normal lives, although they may require lifelong follow-up with a cardiologist.

Epidemiology

The incidence of TGV is relatively rare, though it is one of the more common cyanotic congenital heart defects.

See Also

• Congenital heart defect
• Cyanotic heart defect
• Pediatric cardiology