Transposition of the Great Arteries (TGA) | Research and Clinical Trials

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Contact the Complex Biventricular Repair Program

Pediatric cardiologists and pediatric cardiovascular surgeons at Boston Children's Hospital have pioneered the interventional catheterization techniques now used widely for many congenital heart defects, such as transposition of the great arteries.

And a significant amount of the groundbreaking cardiac research currently being conducted at Boston Children’s aims to refine and advance the open heart surgery and catheterization procedures that correct congenital heart defects in newborns and young children—including transposition of the great arteries.

Cardiac surgery research

Members of Boston Children’s Cardiac Surgery Research Laboratory—a multidisciplinary team of basic and applied research investigators, all of whom hold faculty appointments at Harvard Medical School—are studying the mechanisms of heart disease and new treatments for children with congenital heart defects.

Some principal areas of active research are:

  • surgical robotics and ultrasound-guided intracardiac surgery: The department is pioneering the use of 3-D ultrasound and laparoscopic techniques to operate on the beating heart.
  • myocardial metabolism and myocardial hypertrophy and heart failure: Researchers are exploring new methods of myocardial preservation during heart surgery and the role of angiogenic growth factors in heart failure.
  • tissue engineering to stimulate the growth of new tissue to repair congenital defects, including valve abnormalities, right ventricular defects and arrhythmias

Learn more about  Boston Children’s cardiac research initiatives.

Cardiology research

Boston Children’s is a world leader in opening new avenues of “translational research,” bringing laboratory advances to the bedside and doctor’s office as soon as possible. Senior medical staff members of the Department of Cardiology—all of whom hold faculty appointments at Harvard Medical School—participate in clinical research activities, and many do laboratory research, as well.

Learn more about Boston Children’s current projects in cardiology research.


The Nikaidoh procedure

The Nikaidoh procedure is an innovative aortic translocation operation for treating transposition of the great arteries when a VSD and pulmonary stenosis are present—a rare combination of defects. The procedure is performed at only at Boston Children’s and a handful of other specialty centers.

In this procedure, the aorta is switched, along with the aortic valve, and is placed in the pulmonary position—avoiding leaks of the abnormal pulmonary valve on the right side.

To follow our patients long term, Boston Children’s uses one of the only MRI scanners dedicated to pediatric cardiology. With our scanner, we can observe features like ventricular size and function, and we can look for the development of valve leakiness, obstruction of the great arteries or coronary artery obstruction.

Creating new ways to perform surgery

Problem: When surgeons perform heart surgery on a baby, they need to open the infant’s chest and stop her heart—an inva­sive, lengthy procedure that can cause life-threatening complications. Recognizing that there is much room for improvement, Pedro del Nido, MD, chief of Cardiac Surgery at Boston Children’s, has developed a novel research program to invent new ways to improve the way that surgeons do cardiac operations.

Innovative solution: Del Nido decided to develop a way to perform surgery on a still-beating heart. But he needed two things that didn’t exist: superior imaging tools that could show the structures inside the heart while it’s beating, and tiny instruments to perform the intricate surgery.

So, he bor­rowed technology from the videogame industry and developed stereo-rendered 3-D ultrasound imaging that allows surgeons to see inside the beating heart as a hologram.

Del Nido also designed new instruments. One is a millimeter-sized tool that extends into the heart through needle-sized incisions. Using a joystick controller and real-time imaging, a surgeon can now navigate through the beating heart’s chambers in animals to remove blockages, repair faulty valves and close leaks.

The other new instrument is a cardioport device that allows instruments to be safely introduced into the cardiac chambers with­out the usual risks of blood loss or an air embolism.

Results: Del Nido’s 3-D tool appears not only to provide superior imaging, but also to yield faster surgery times. Researchers using it to operate on pigs with congenital heart disease performed the procedure 44 per­cent faster than before. Dr. Del Nido’s cardioport will soon be tested in clinical trials and will facilitate further development of similarly novel instruments for heart repair.

Del Nido’s newly-developed cardioport will someday make possible faster, less invasive heart surgery.

We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”
- Sandra L. Fenwick, President and CEO

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