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Transposition of the great arteries (TGA)

The great arteries are the large blood vessels that move blood from the heart to the body and the lungs. Normally, the pulmonary artery that moves blood to the lungs is on the heart's right side. The aorta, that moves blood to the body, is on the heart's left side. When transposed, the great arteries are switched. Two independent circulations will thus occur.

In this condition, unoxygenated blood is being sent to the body, so the affected infant will appear blue at birth. The infant will have a small hole between the upper collecting chambers, called a patent foramen ovale (PFO). The patent ductus arteriosus normally connects the aorta with the pulmonary artery. This channel usually closes as the infant is born. If they remain open some oxygenated blood can get to the body.

Transposition of the great arteries (TGA)

How we treat transposition of the great arteries

To correct this transposition, surgeons can enlarge the PFO to encourage blood mixture. This is known as the Rashkind procedure, which takes place in the catheterization laboratory. A small catheter (flexible tube) is inserted in a large vein in the baby's groin. This catheter passes a balloon across the hole in the upper chamber and pulled back to enlarge it This allows better mixture of unoxygenated blood with oxygenated blood.

Arterial switch is the most common surgery preformed for TGA. Surgeons stop the baby's heart and open it for repair. The aorta is cut above the where it joins the coronary arteries. The pulmonary artery is cut at the same level as the aorta. The coronary arteries and aorta are then reattached to the base of the pulmonary artery. Finally, the pulmonary artery is sewn to the base of the aorta. These changes redirect circulation to cause normal, healthy blood flow.

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