d-transposition of the great arteries (d-TGA)

What is d-transposition of the great arteries (d-TGA)?

d (dextro) -transposition of the great arteries (d-TGA) is a rare congenital heart disease that is present at birth. The reversed placement of the arteries changes the way that blood flows to the lungs and the body. As a result, the blood that reaches your baby’s organs, muscles and tissues is too low in oxygen.

Infants with d-TGA may also have other heart conditions, such as:

• Atrial septal defect - Hole between the heart’s upper pumping chambers (atria)
• Ventricular septal defect - Hole between the heart’s lower pumping chambers (ventricles)
• Patent ductus arteriosus - Opening between the aorta and pulmonary artery

Risk factors

Approximately 1,153 babies are born in the U.S. with d-TGA every year.

What are the different types of d-transposition of the great arteries (d-TGA)?

d-TGA is the most common heart transposition condition. The other type is levo-transposition of the great arteries (l-TGA). d-TGA is often called just TGA. But TGA can refer to d-TGA or l-TGA.

What are the signs and symptoms of d-transposition of the great arteries (d-TGA)?

• Skin that looks blue (cyanosis) due to low oxygen levels
• Fast heart rate
• Rapid breathing

How is d-transposition of the great arteries (d-TGA) diagnosed?

Doctors at our Fetal Heart Program diagnose d-TGA during pregnancy. Or newborn screening tests while your baby is in the nursery may show low levels of oxygen in the blood.

At Children’s Health, we use the latest cardiac imaging to diagnose the condition and create an effective treatment plan for your child.

Diagnostic tests may include:

• Chest X-ray
• Electrocardiogram (EKG)
• Echocardiogram
• CT scan
• MRI

What causes d-transposition of the great arteries (d-TGA)?

Congenital heart diseases like d-TGA happen for no known reason. Something happens while a baby is developing inside the womb that causes the arteries to switch positions. There isn’t anything a pregnant woman can do or not do to prevent this heart condition.

How is d-transposition of the great arteries (d-TGA) treated?

Newborns with d-TGA need immediate treatment soon after birth. We partner with your hospital to quickly start therapies and bring your baby to The Heart Center at Children’s Health for corrective heart surgery.

Before getting surgery, your baby may need:

• IV medicine to keep the ductus arteriosus (a blood vessel that allows blood to flow between the aorta and pulmonary artery) open so the body gets more blood with oxygen
• Balloon atrial septostomy to widen an atrial septal defect and allow more blood with oxygen to reach the body

Arterial switch operation

To correct d-TGA, our experienced heart surgeons perform a complex open-heart procedure called an arterial switch operation. This surgery takes place within an infant’s first seven to 10 days of life.

Surgery involves moving and reconnecting the aorta and pulmonary artery to the correct heart chambers. d-TGA is very rare. Every year, our surgical team successfully performs dozens of these complex arterial switch operations. Our success rates helping children are as high as 98%.

Other problems, such as holes in the heart, are repaired at the same time.