Transposition of the Great Arteries (TGA) | Treatments

What are the treatment options for transposition of the great arteries?

After birth, a newborn with transposition of the great arteries (TGA) will be admitted to Boston Children's Hospital's cardiac intensive care unit (CICU). Initially, he or she may be placed on oxygen or a ventilator to help with breathing, and IV (intravenous) medications may be given to help the heart and lungs function more efficiently.

Once stabilized, the baby's treatments may include:

Medication: Doctors may administer an IV (intravenous) medication (prostaglandin E1) to keep open the infant's ductus arteriosus (the prenatal connection between the aorta and the pulmonary artery, which usually closes shortly after birth, but which is now important as an alternative pathway for blood flow).

Cardiac catheterization: Before TGA surgery, doctors may perform a cardiac catheterization procedure called balloon atrial septostomy to improve the mixing of oxygen-rich (red) blood and oxygen-poor (blue) blood. A special catheter with a balloon in the tip is used to create or enlarge an opening in the atrial septum (wall between the left and right atria).

Surgery: Within a baby's first two weeks, transposition of the great arteries is surgically repaired through a procedure called an “arterial switch.” While supported by a heart-lung machine, the aorta and pulmonary arteries are disconnected, then “switched” and reconnected to their proper ventricles.

As part of the procedure, the coronary arteries are transferred to the new aorta. In addition, any holes between the chambers of the heart are closed. 

What is the long-term outlook for children with transposition of the great arteries?

The Heart Center team continues to refine their management of TGA and incorporate the latest innovations and research. Most children who've had TGA surgery recover and grow normally. Even so, your child will need periodic monitoring, since he or she may be at increased risk for arrhythmias, leaky valves, narrowing of the arteries and other heart issues.

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