Overview

It is also called dextro-transposition, the transposition of the great arteries, a congenital heart defect characterized by an inversion of the heart's arteries. An inversion affects blood oxygen levels and, in some instances, if untreated, might make life fatal. Without corrective surgery, a TGA can prove deadly. Nevertheless, if they receive lifetime care from a cardiologist, the patient diagnosed with d-TGA can lead long, healthy lives.

What is a transposition of the great arteries in children?

Transposition of the great arteries is a congenital heart disease. It means the baby is born with it. In dextro-transposition or d-TGA, the two highways that bring blood downward from your baby's heart have been reversed (transposed). The two arteries are-

The main pulmonary artery, which takes blood into the lungs.
The aorta, the artery that takes blood from the heart to the rest of the body.

People sometimes refer to the great arteries' transposition as the great vessels' transposition.

Dextro- Transposition of the great arteries
D- Transposition.
D- TGA.

What is the cause of the transposition of the great arteries (TGA)?

The cause of most of the transposition of the great arteries in TGA is unknown.

What are the symptoms of transposition of the great arteries (TGA) in children?

Newborns with TGA have blue skin color (cyanosis) in their first hours or days.

Other symptoms could include:

Rapid breathing
Difficulty breathing
Fast heart rate.
Poor feeding.

The symptoms of TGA can be analyzed based on the signs and symptoms of other diseases. Make sure your child visits their physician to receive an opinion.

How is transposition of the great arteries (TGA) diagnosed in a child?

A pediatric cardiologist or neonatologist will evaluate them to see if your child has signs of TGA after birth. A pediatric cardiologist is a doctor with specialized training in treating heart problems in babies and children. A neonatologist is a doctor with special training in treating problems in babies. These doctors will be part of your baby's heart care platoon.

The doctor might conduct tests to confirm the diagnosis. Depending on their age and condition, the type of test administered to your child will depend on the doctor's preference.

Pulse Oximetry: A sensor is applied to your child's thigh or toe. This test measures the oxygen level in the blood, and if the level falls below a specific level, it could indicate TGA.
Chest X-ray: This shows the size and shape of the heart and lungs.
Electrocardiogram (ECG): This records the heart's electrical exertion. It also signifies abnormal arrhythmias or dysrhythmias and spots heart muscle stress.
Echocardiogram (echo): An echo uses sound swells to make a moving picture of the heart and heart valves. This test may show TGA.
Cardiac catheterization (cardiac or heartcath): Cardiac catheterization provides detailed information concerning the inner structure of the heart. In this test, a small, flexible tube referred to as a catheter is inserted into a blood vessel in your child's groin. The doctor also takes care of your child's heart. Before performing the test, he will dress your child in a different color so that they can see their heart more clearly. The test measures the pressure and oxygen content in the four chambers of your child's heart, pulmonary artery, and aorta. Your child will receive medications to decrease tension and pain (sedation).

What is the treatment for the transposition of the great arteries in a child?

Surgery is required for all babies with D-TGA, which involves the correction of the heart defect. L-TGA requires treatment that varies with the timing of diagnosis and the presence of other heart defects.

Medication-

Alprostadil (Caverject, Edex, and other brands) can be administered to the baby before the surgery to correct the switched arteries. This drug improves blood flow and enhances the blood's ability to combine components with and without oxygen.

The following procedures and other medical interventions can be used in treating the transposition of the great arteries:

Atrial septostomy: This treatment can be administered instantly in the early stages before surgery as a temporary measure. It involves making small incisions and thin tube connections in the upper chambers of the heart. The procedure mixes the baby's oxygen-poor and oxygen-rich blood, improving the oxygen saturation levels. This is the most common procedure to treat the great artery transposition. In this procedure, the two biggest arteries that come off from the heart are switched to their actual positions. All other birth defects that may be related to the heart may be corrected during this procedure.
Atrial switch operation: The surgeon separates the blood flow between the two top chambers of the heart. After this procedure, the surgeon has to pump the blood from the right lower chamber of the heart to the whole body instead of just the lungs.
Rastelli process: If there is a baby born with TGA, and at the same time, this baby also suffers from a ventricular septal defect;a hole in the heart—the surgeon has no choice but to carry out this procedure. The surgeon closes the hole and then re-orients the flow of blood from the left lower chamber of the heart to the aorta. This allows the body's entry of blood full of oxygen. The lung artery and the right lower chamber of the heart are joined through an artificial valve.
Double switch procedure: This complicated procedure is used in treating congenitally repaired transposition. It changes the flow of blood into the heart. For the left lower chamber of the heart to pump its richly oxygenated contents into the aorta, it changes the major artery's connections. TGA babies often have other defects at birth. It may require more interventions to correct such heart defects. Surgery may also be needed in the management of TGA complications. If the TGA leads to changes in the rhythm of the heartbeat, a pacemaker might be recommended.

After TGA repair surgery, the patient requires lifelong follow-up in the office of a physician trained in the treatment of congenital cardiac defects. Such a specialist is known as a congenital cardiologist.

Can transposition of the great arteries be diagnosed before birth?

Your obstetrician may diagnose d-TGA when you are pregnant. Prenatal checks screen for conditions such as heart defects. That being said, your doctor may suggest a fetal echocardiogram if a prenatal ultrasound detects anything amiss. This is less intrusive than an ultrasound and more through. It can help to confirm the validity of a d-TGA opinion.

Living with

How should I take care of my child?

Your child will be staying in the sanitarium until the time of surgery.

The doctors and nurses who will care for your child will visit with you and make recommendations as to how best to care for your baby at home. This person may also discuss some information related to in-home pediatric medical care if you need it. In general, children who receive surgery for this condition will do well in terms of recovery.

Your child's doctor should be consulted for a prognosis. Your child will still have to visit their heart doctor for follow-up exams. Your child might need more heart catheterizations or surgery in the future. Your child's dentist may prescribe antibiotics before any procedures or dental work. This helps to heal infections. Your child should limit their level of physical activity. Your child might be limited in participating in certain sports.

Why Tender Palm Super-Speciality Hospital for Pediatric Transposition of the Great Arteries?

Tender Palm Hospital has the most experienced team of Pediatric Cardiologists, Pediatric Cardiac Surgeons, and diagnostics with the latest and International standard infection control measures in Lucknow, India. The Pediatric Cardiac Science Centre team has decades of experience in successfully treating Pediatric Transposition of the Great Arteries.