Diagnosis
Transposition of the great arteries, also called TGA, is often diagnosed before birth during a routine pregnancy ultrasound. If not, it is diagnosed soon after birth.
Immediately after birth, a healthcare professional listens to the baby's heart and lungs. A whooshing heart sound, called a murmur, may be heard while listening to the baby's heart. Some murmurs are caused by blood flow changes to and from the heart.
Tests
Tests to diagnose transposition of the great arteries include:
- Echocardiogram. Sound waves make images of the beating heart. An echocardiogram shows how blood moves through the heart and heart valves. It can tell if the two main arteries leaving the heart are in the correct position. If the test is done on an unborn baby before birth, it's called a fetal echocardiogram.
- Chest X-ray. This test shows the condition of the heart and lungs. It can't diagnose TGA by itself, but it helps show the heart's size.
- Electrocardiogram (ECG or EKG). This simple test shows how the heart is beating. Sticky patches with sensors on them go on the chest and sometimes the arms and legs. Wires connect the sensors to a computer, which prints or displays the test results.
- Pulse oximetry. A sensor placed on the fingertip records the amount of oxygen in the blood. Too little oxygen may be a sign of a heart or lung condition.
More Information
Treatment
Treatment depends on the type of transposition of the great arteries.
All babies with complete transposition of the great arteries, also called d-TGA, need surgery soon after birth to fix the heart.
Treatment for congenitally corrected transposition, also called l-TGA, depends on:
- When the condition is diagnosed.
- What other heart conditions exist.
Medications
Before heart repair surgery, the baby may get a medicine called prostaglandin (Prostin Vr Pediatric) . The medicine increases blood flow. It helps oxygen-poor and oxygen-rich blood better mix together.
After surgery to fix TGA, medicines are given to help the heart work better. Medicines may be needed to:
- Control the heartbeat.
- Manage blood pressure.
- Help the body remove fluid.
Surgery or other procedures
Surgery for transposition of the great arteries, also called TGA, is usually done within the first days to weeks after birth. The specific surgery done depends on the type of TGA. Some people with congenitally corrected transposition do not need surgery.
Treatment may include:
- Atrial septostomy. This treatment may be done right away as a temporary fix before surgery. It uses thin tubes and small cuts to widen a natural connection between the heart's upper chambers. Doing this helps mix oxygen-rich and oxygen-poor blood, improving oxygen levels in the baby's body.
- Arterial switch operation. This is the most common surgery used to correct transposition of the great arteries. A surgeon moves the two main arteries, leaving the heart to their correct positions. The surgeon also has to move the coronary arteries. Other heart conditions present at birth may be repaired during this surgery.
- Atrial switch operation. The surgeon splits blood flow between the heart's two upper chambers. After this surgery, the right lower heart chamber must pump blood to the body, instead of just to the lungs.
- Rastelli operation. This surgery may be done if a baby with TGA also has a hole in the heart called a ventricular septal defect. The surgeon patches the hole and redirects blood flow from the left lower heart chamber to the aorta. This lets oxygen-rich blood go to the body. An artificial valve connects the right lower heart chamber to the lung artery.
- Double switch procedure. This complex surgery is used to treat congenitally corrected transposition. It switches the great artery connections so the left lower heart chamber can pump oxygen-rich blood to the aorta.
Babies born with TGA often have other heart conditions. Other heart surgeries may be needed. Surgery also may be needed to treat complications of TGA. If TGA causes changes in the heartbeat, a device called a pacemaker may be needed.
After surgery to fix TGA, regular health checkups are needed for life. A doctor trained in heart conditions present at birth usually cares for a baby with transposition of the great arteries. This type of doctor is called a congenital cardiologist.
Every situation is different. But due to advances in surgery, most babies with transposition of the great arteries grow up to lead active lives.
Clinical trials
Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.
Coping and support
Caring for a baby with a serious heart condition, such as transposition of the great arteries, can be challenging. These tips might help.
- Get support. Ask for help from family members and friends. Talk with your baby's healthcare team about support groups and other types of assistance that are available near you.
- Keep notes about the baby's health history. Write down the diagnosis, medicines, surgeries and other treatments. Include the dates of treatments and the names and phone numbers of all the healthcare professionals. Such notes are helpful for healthcare professionals who are unfamiliar with your baby's health history.
- Ask about activities and sports. After surgery to fix TGA, some high-energy activities might not be safe to do. Talk with a healthcare professional about which exercises or activities are safe.
Preparing for your appointment
A life-threatening congenital heart defect is usually diagnosed soon after birth. There may not be time to prepare for the appointment.
If you think your baby has symptoms of a heart condition, talk with a healthcare professional. You may be sent to a doctor trained in heart conditions present at birth, called a congenital cardiologist.
Here's some information to help you prepare for any appointments.
What you can do
Take someone with you to the appointment, if possible. Sometimes it can be hard to remember all of the information that you get. Someone who goes with you may be able to remember details.
Make a list of:
- Your child's symptoms, if any. Include those that may seem unrelated to transposition of the great arteries. Also note when they started.
- Important personal information, including a family history of congenital heart defects. Ask if anyone in your family was born with a heart condition.
- Questions to ask the healthcare professional.
For transposition of the great arteries, some questions to ask the healthcare professional are:
- Does my baby need surgery?
- What other treatments are available? Which do you recommend?
- How often does my baby need health checkups?
- Are there any activity limits?
- Is there any information that I can take home with me? What websites do you recommend?
Don't hesitate to ask other questions.
What to expect from your doctor
Your healthcare team usually asks you many questions, such as:
- Was anyone in your family born with a heart condition?
- Were there any pregnancy complications?
- Has your child been growing and meeting developmental milestones as expected? Ask your child's pediatrician if you're not sure.