Introduction: Understanding Transposition of the Great Arteries (TGA)

Transposition of the Great Arteries (TGA) is a serious heart condition that a baby is born with (a congenital heart defect). In a healthy heart, the two main blood vessels—the pulmonary artery and the aorta—are connected to the heart in the correct positions. The pulmonary artery takes blood from the heart to the lungs, and the aorta carries oxygen-rich blood from the heart to the rest of the body.

In TGA, these two arteries are switched. This means that oxygen-poor blood flows to the body instead of to the lungs, and oxygen-rich blood goes back to the lungs instead of the body. Because of this, the baby's body doesn't get enough oxygen. This is a medical emergency and needs quick diagnosis and surgery to fix the problem.

Common names for this condition include:

1. Transposition of the Great Arteries (TGA)

2. Complete Transposition of the Great Arteries

3. Dextro-Transposition of the Great Arteries (d-TGA)

Transposition of the great arteries symptoms often appear very soon after birth. These may include:

1. Blue or purple skin color (cyanosis)

2. Fast breathing

3. Difficulty feeding

4. Poor weight gain

5. Cold hands and feet

6. Sleepiness or being very tired all the time

This condition is life-threatening if not treated quickly. But the good news is that with the right medical care and surgery, babies with TGA can go on to live healthy lives.

More Information About Transposition of the Great Arteries (TGA)

What Exactly Happens in TGA?
(a) In a normal heart:

1. The right side pumps oxygen-poor blood to the lungs through the pulmonary artery.
2. The left side pumps oxygen-rich blood to the body through the aorta.

(b) In TGA:

1. The pulmonary artery and aorta are switched.
2. The right side sends oxygen-poor blood back to the body, and the left side sends oxygen-rich blood back to the lungs.
3. This creates two separate blood circuits that do not mix—so the body doesn't get enough oxygen, which is dangerous and life-threatening.

Common Transposition of the Great Arteries Symptoms

1. Symptoms often appear in the first hours or days after birth, including:
2. Bluish skin or lips (cyanosis)
3. Breathing difficulties
4. Poor feeding or no interest in feeding
5. Lethargy or unusual sleepiness
6. Cold hands and feet
7. Poor weight gain

These signs mean the baby is not getting enough oxygen and needs urgent medical care.

How Is TGA Diagnosed?
Doctors usually suspect TGA soon after birth based on symptoms. Diagnosis is confirmed using:

1. Pulse oximetry (measuring oxygen levels)
2. Echocardiogram (ultrasound of the heart)
3. Chest X-ray
4. Cardiac catheterization (in rare cases)

Transposition of the Great Arteries Treatment Options
1. Medication (temporary solution):
Some babies are given a medicine called Prostaglandin E1 to keep a small hole open in the heart (ductus arteriosus), which allows some mixing of oxygen-rich and oxygen-poor blood.

2. Balloon Atrial Septostomy (temporary procedure):
A special catheter is used to create or enlarge a hole between the heart’s upper chambers. This helps mix blood and gives more time before surgery.

3. Arterial Switch Operation (main surgery):
This is the standard Transposition of the Great Arteries surgery, usually done within the first 2–3 weeks of life.

The surgeon:

1. Switches the aorta and pulmonary artery back to their correct positions.
2. Moves the coronary arteries (blood vessels supplying the heart) to the new aorta.

This surgery restores normal blood flow and oxygen supply to the baby’s body. It has a high success rate when done early.

Recovery After Surgery

1. Most babies stay in the hospital for 2–3 weeks after surgery.
2. They are monitored in the Pediatric ICU (PICU).
3. Recovery includes feeding support, medication, and breathing help if needed.

Regular check-ups are needed after surgery to track heart function and overall development.