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Transposition of the Great Arteries

Treatment

Initial treatment for TGA occurs during childhood, but adult TGA patients receive ongoing care and maintenance.

Unless another congenital heart defect is present, the majority of infants with l-TGA don’t need surgical treatment. However, surgery is sometimes recommended in adulthood to implant a pacemaker or replace a leaky heart valve. Medication might also be prescribed to decrease symptoms or improve heart function.

Surgery is essential for patients with d-TGA. Typically, surgery is done during the first week of life. There are multiple surgical procedures available to treat d-TGA.

Before surgery, babies with d-TGA are given a medication called prostaglandin E1. Often, a procedure called a balloon atrial septostomy is then done. These treatments help increase circulation of oxygen-rich blood and stabilize the baby for surgery.

Today, the most common surgery for d-TGA is the arterial switch operation. In this procedure, the surgeon switches the positions of the aorta and pulmonary artery. The aorta is surgically connected to the left ventricle, and the pulmonary artery is connected to the right ventricle. Finally, the coronary arteries are reattached to the newly positioned aorta.

From the 1950s to the 1980s, another standard treatment was intra-atrial baffle, also called atrial or venous switch or the Mustard or Senning procedure. During this surgery, a baffle, or tunnel, is created between the heart’s upper chambers, redirecting blood flow. Although this procedure is no longer common, many adults with d-TGA had this procedure as infants.

Additional treatments may be needed in adulthood to address possible late complications of surgery, including:

  • Aortic regurgitation, which is when blood flows backward
  • Arrhythmias, or abnormal heart rhythms
  • Blockage or leakage in the tunnel created to connect the right and left atria
  • Heart valve issues
  • Narrowing, or stenosis, of the coronary artery

Treatments for these complications might include: