PEDIATRIC SERVICES

Diagnosis & Treatment

Transposition of the Great Arteries (TGA)

Diagnosis

What is Transposition of the Great arteries Arteries (TGA)?

Transposition of the great arteries (TGA) is a heart defect generally diagnosed at birth. A newborn will typically have blue skin, difficulty breathing, or a weak pulse. Your doctor or a pediatric cardiologist will perform an exam to check the heart and lungs and measure oxygen levels in the blood.

An abnormal whooshing sound in the baby’s heart can indicate the presence of TGA. A doctor can confirm a diagnosis with additional tests:

  • Chest X-ray. While an X-ray won’t provide a detailed image of the heart, it can help determine its size and if any blood flow is collecting in the lungs
  • Echocardiogram. This imaging test uses sound waves to create a more detailed image of the heart, revealing the position of the pulmonary artery and the aorta
  • Electrocardiogram (EKG or ECG). Sticky electrodes are placed on your baby’s heart to monitor its electrical activity and see if the heart is beating irregularly
  • Cardiac MRI. This test produces a 3-dimensional image of the heart and any abnormalities
  • Cardiac catheterization. A thin, flexible tube is passed through an artery or vein (via the leg or belly button) and into the heart. Cardiac catheterization helps collect detailed information about the heart’s activity.

A baby can also be diagnosed with TGA during pregnancy via the following tests:

  • Prenatal ultrasounds can detect signs of a congenital heart defect
  • Cardiac ultrasounds produce a more detailed look at the baby’s heart in utero

How is Transposition of the Great Arteries (TGA) Treated?

Treatments

Most babies born with TGA require surgery soon after birth. Transposition of the great arteries surgery generally involves taking certain medications and a cardiac catheterization before the procedure.

Medications

Before TGA surgery, medication may be given to increase blood flow, promoting the integration of oxygen-rich and oxygen-poor blood. Medication, such as Alprostadil, can be administered intravenously.

Surgery for transposition of the great arteries

Surgery for TGA will switch and reconnect the aorta and pulmonary artery to their proper places. This will redirect the blood flow, sending oxygen-poor blood to the lungs and oxygen-rich blood to the rest of the body. Your baby will be able to get the oxygen they need. 

If there are no underlying risk factors, the life expectancy after transposition of the great arteries surgery is high. More than 98% of infants survive the surgery and their infancy. 

Without surgery to correct transposition of the great arteries, the life expectancy rates are low. Over 50% of patients will die in the first month and 90% within their first year.

Post-Surgical Care

Most babies will need to stay in the hospital for around two weeks following transposition of the great arteries surgery. The majority of children do not require additional surgery, but older patients at some point may need another procedure. 

More than 90% of babies who undergo TGA surgery grow into adulthood and lead healthy lives but will need lifelong check-ins with a cardiologist. They may also be directed to avoid strenuous activities, such as competitive sports, to avoid a rise in blood pressure and stress on the heart.

Women who received surgery for TGA and wish to become pregnant should speak with their obstetrician and cardiologist before conceiving. Special care and testing may be needed. 

 

Get Care

Trust NewYork-Presbyterian for TGA Treatment

NewYork-Presbyterian Congenital Heart Center provides safe, innovative, and successful treatments for an array of pediatric heart defects. When signs and symptoms of transposition of the great arteries appear, our specialists and world-renowned surgeons are here for your child—from the womb through infancy, childhood, and adulthood.

Contact NewYork-Presbyterian today for unparalleled cardiac care.