Definition

Transposition of the great arteries (TGA) is a congenital heart defect in which the two main blood vessels that carry blood away from the heart – the aorta and the pulmonary artery – are switched or “transposed” in their normal positions. This results in a disruption of the normal blood flow, requiring immediate medical intervention.

Pathophysiology

In TGA, the aorta is connected to the right ventricle, while the pulmonary artery is connected to the left ventricle. This reversal of the great arteries means that deoxygenated blood is pumped back to the body, while oxygenated blood is pumped back to the lungs, leading to a life-threatening lack of oxygen circulation.

Signs and Symptoms

Newborns with TGA often exhibit cyanosis, or a bluish discoloration of the skin, due to the lack of oxygen in the blood. They may also experience difficulty breathing, poor feeding, and lethargy.

Diagnostic Tests and Differential Diagnosis

Echocardiography is the primary diagnostic tool used to confirm the presence of TGA. Other tests, such as electrocardiography and cardiac catheterization, may be used to assess the severity of the condition and rule out other potential heart defects.

Diagnosis and Treatment Approaches

Prompt diagnosis and treatment are crucial for the survival of infants with TGA. Immediate medical intervention, often within the first few days of life, is required to stabilize the patient and prepare for corrective surgery. The most common surgical approach is the arterial switch operation, which involves switching the positions of the aorta and pulmonary artery.

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Conclusion

Transposition of the great arteries is a complex and life-threatening congenital heart defect that requires immediate medical attention. With advancements in diagnostic techniques and surgical interventions, the prognosis for infants with TGA has significantly improved, allowing them to lead healthy and active lives.