Materiały źródłowe

• #1 Transposition of the Great Arteries | Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/t/transposition

  Transposition of the great arteries can be diagnosed by a fetal ultrasound. This can be missed on a routine fetal ultrasound. Sometimes, a fetal echocardiogram done by specialists is needed to make a diagnosis of transposition in a fetus. […] After birth, transposition is diagnosed in the first hours or days of life due to cyanosis or low oxygen levels. All babies have a patent ductus arteriosus (PDA) at birth that may allow enough mixing to prevent severe cyanosis. As the ductus arteriosus closes, as it will in the first hours or days of life, cyanosis gets more severe. […] Echocardiography can quickly show the abnormal connections of the great arteries and other features of the cardiac anatomy. This includes the presence and size of an atrial or ventricular septal defect and the branching patterns of the coronary arteries. […] If questions about the anatomy, such as the coronary artery pattern remain, cardiac catheterization or cardiac MRI may be done to get more details of the defect.

• #2 Transposition of the Great Arteries (TGA)

  https://my.clevelandclinic.org/health/diseases/23387-transposition-of-the-great-arteries

  Transposition of the great arteries is a congenital heart condition that happens when the two main arteries going away from your heart are in the wrong places. […] Your healthcare provider may diagnose transposition of the great vessels during pregnancy. Prenatal tests check for congenital conditions. […] If your provider notices a concern during a prenatal ultrasound, they may recommend a fetal echocardiogram. This noninvasive test is a detailed ultrasound. It can confirm a d-TGA diagnosis. […] To diagnose transposition of the great arteries, providers can use: Echocardiogram (Echo). […] Babies born with the d type of transposition of the great arteries need surgery to survive. Many babies with d-TGA have surgery within the first week of life. Surgeons perform an arterial switch procedure, which involves switching the positions of your babys aorta and pulmonary artery. […] The survival rate after an arterial switch surgery is more than 95%. This survival rate stands even 25 years later.

• #3 Prenatal diagnosis of transposition of the great arteries: an updated review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7515665/

  Simple transposition of the great arteries (TGA) is a cyanotic heart disease that accounts for 5% to 7% of all congenital heart diseases. It is commonly underdiagnosed in utero, with prenatal detection rates of less than 50%. […] The prenatal diagnosis of TGA influences postnatal outcomes and therefore requires planned delivery and perinatal management. […] The presence of two vessels instead of three in the three-vessel tracheal view, a parallel course of TGA, and identification of the origin of each of TGA are the key markers for diagnosing TGA. […] The fetal diagnosis of TGA is based on identification of the bifurcation of the great vessel (pulmonary artery), which arises from the posterior ventricle (LV), and is aided by the parallel course of TGA. […] The prenatal diagnosis of TGA may have an impact on postnatal outcomes and therefore requires planned delivery and perinatal management. […] The diagnosis of TGA in fetuses has been traditionally confirmed by identifying the bifurcation of the vessel from the LVOT, which is not easy to achieve. However, the LVOT should be assessed if a long vessel with a rightward reverse curvature arises in the aorta.

• #4 About dextro-Transposition of the Great Arteries (d-TGA) | Congenital Heart Defects (CHDs) | CDC

  https://www.cdc.gov/heart-defects/about/d-tga.html

  Dextro-Transposition (pronounced DECKS-tro trans-poh-ZI-shun) of the Great Arteries or d-TGA is one type of congenital heart defect. Congenital means present at birth. […] d-TGA may be diagnosed during pregnancy or soon after the baby is born. […] During pregnancy, screening tests (prenatal tests) check for birth defects and other conditions. An ultrasound, a tool that creates pictures of the baby, may detect d-TGA. If the health care provider suspects d-TGA from the ultrasound, they can request a fetal echocardiogram to confirm the diagnosis. […] Because the infant with d-TGA might be bluish in color and have trouble breathing, d-TGA is usually diagnosed within the first week of life. The healthcare provider might request additional tests to confirm the diagnosis. The most common test is an echocardiogram, which is an ultrasound of the heart. An echocardiogram can show incorrect positioning of the two large arteries and any irregular blood flow. […] d-TGA can also be detected with newborn pulse oximetry screening. Newborn screening using pulse oximetry can identify some infants with d-TGA before they show any symptoms.

• #5 Transposition of the Great Arteries Diagnosis & Treatments | Mount Sinai – New York

  https://www.mountsinai.org/locations/childrens-heart/conditions/transposition-great-arteries

  When your baby is born with a congenital (present at birth) heart disease like transposition of the great arteries (TGA), you will likely go into overdrive to seek the best possible care. […] TGA is often diagnosed in utero, or we may diagnose TGA within the first few hours or days of your baby’s life. […] To diagnose TGA in a newborn baby, our pediatric cardiologist will perform tests, such as: […] Chest X-ray—takes pictures of the your child’s heart, lungs, and blood vessels, and can show if the heart is enlarged […] Echocardiogram (also known as an echo or cardiac ultrasound)—uses ultrasound waves to create an image of the size, shape, and movement of your child’s heart, valves, and chambers. It also shows how blood flows. It is a safe, noninvasive procedure […] Electrocardiogram (ECG or EKG)—records the electrical activity or rhythm of the heart that shows how your child’s heart is beating. It is non-invasive procedure using stickers that are placed on your child’s chest […] Pulse oximetry—monitors the oxygen content of your child’s blood without drawing blood.

• #6 Prenatal diagnosis of transposition of the great arteries: an updated review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7515665/

  Simple transposition of the great arteries (TGA) is a cyanotic heart disease that accounts for 5% to 7% of all congenital heart diseases. It is commonly underdiagnosed in utero, with prenatal detection rates of less than 50%. […] The prenatal diagnosis of TGA influences postnatal outcomes and therefore requires planned delivery and perinatal management. […] The presence of two vessels instead of three in the three-vessel tracheal view, a parallel course of TGA, and identification of the origin of each of TGA are the key markers for diagnosing TGA. […] The fetal diagnosis of TGA is based on identification of the bifurcation of the great vessel (pulmonary artery), which arises from the posterior ventricle (LV), and is aided by the parallel course of TGA. […] The prenatal diagnosis of TGA may have an impact on postnatal outcomes and therefore requires planned delivery and perinatal management. […] The diagnosis of TGA in fetuses has been traditionally confirmed by identifying the bifurcation of the vessel from the LVOT, which is not easy to achieve. However, the LVOT should be assessed if a long vessel with a rightward reverse curvature arises in the aorta.

• #7 Prenatal diagnosis of transposition of the great arteries: an updated review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7515665/

  Simple transposition of the great arteries (TGA) is a cyanotic heart disease that accounts for 5% to 7% of all congenital heart diseases. It is commonly underdiagnosed in utero, with prenatal detection rates of less than 50%. […] The prenatal diagnosis of TGA influences postnatal outcomes and therefore requires planned delivery and perinatal management. […] The presence of two vessels instead of three in the three-vessel tracheal view, a parallel course of TGA, and identification of the origin of each of TGA are the key markers for diagnosing TGA. […] The fetal diagnosis of TGA is based on identification of the bifurcation of the great vessel (pulmonary artery), which arises from the posterior ventricle (LV), and is aided by the parallel course of TGA. […] The prenatal diagnosis of TGA may have an impact on postnatal outcomes and therefore requires planned delivery and perinatal management. […] The diagnosis of TGA in fetuses has been traditionally confirmed by identifying the bifurcation of the vessel from the LVOT, which is not easy to achieve. However, the LVOT should be assessed if a long vessel with a rightward reverse curvature arises in the aorta.

• #8 Transposition of the Great Arteries (TGA) | Doctor

  https://patient.info/doctor/transposition-of-the-great-arteries

  Transposition is the most common cyanotic congenital heart lesion presenting in the neonate. It constitutes 3% of all congenital heart disease (CHD) and 20% of all neonatal cyanotic CHD. […] The overall annual incidence is 1 in 4,000 live births. […] Antenatal diagnosis of TGA results in better clinical status before surgery and improved postoperative outcome. […] The prenatal detection rate of TGA on antenatal ultrasound has improved with inclusion of additional outlet views but still remains below 50%. […] Pulse oximetry done on day 1 of life is likely to show low saturations suggesting the possibility of cyanotic heart disease. […] Echocardiography (two-dimensional and colour Doppler) usually provides all the anatomical and functional information needed for diagnosis and management of these babies.

• #9 Managing transposition of the great arteries in the womb – Children’s National

  https://innovationdistrict.childrensnational.org/managing-transposition-of-the-great-arteries-in-the-womb/

  Despite the challenging diagnosis for many obstetricians, this fetus heart condition was recognized early by looking at the arteries leaving the heart in addition to the chambers. […] While such a defect is fatal if left untreated, Dr. Donofrio explains there are two pathways that can allow the blood to get to where it needs to go such that the circulation is stabilized and the damage mitigated. […] By keeping those two pathways open, blood can cross from one side of the heart to the other, buying time in the delivery room so that babies can be stabilized before they receive surgery to permanently move the arteries back to their normal position. […] The baby was delivered by Cesarean section in the cardiac operating room at Childrens. […] The cardiac intervention team immediately created a hole where the foramen ovale should have been by using a balloon to open the tissue that had closed. […] The baby is now 1-year-old, Dr. Donofrio says, and is healthya scenario that likely wouldnt have happened had the fetal team not made the diagnosis and continually monitored the condition in the womb. […] Now, we can spot problems early and do something about it.

• #10 Transposition of the Great Arteries | Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/t/transposition

  Transposition of the great arteries can be diagnosed by a fetal ultrasound. This can be missed on a routine fetal ultrasound. Sometimes, a fetal echocardiogram done by specialists is needed to make a diagnosis of transposition in a fetus. […] After birth, transposition is diagnosed in the first hours or days of life due to cyanosis or low oxygen levels. All babies have a patent ductus arteriosus (PDA) at birth that may allow enough mixing to prevent severe cyanosis. As the ductus arteriosus closes, as it will in the first hours or days of life, cyanosis gets more severe. […] Echocardiography can quickly show the abnormal connections of the great arteries and other features of the cardiac anatomy. This includes the presence and size of an atrial or ventricular septal defect and the branching patterns of the coronary arteries. […] If questions about the anatomy, such as the coronary artery pattern remain, cardiac catheterization or cardiac MRI may be done to get more details of the defect.

• #11 Transposition of the great arteries – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/transposition-of-the-great-arteries/diagnosis-treatment/drc-20350595

  Transposition of the great arteries is most often diagnosed after a baby is born. But sometimes the condition may be seen before birth during a routine pregnancy ultrasound. If so, an ultrasound of the unborn baby’s heart may be done to confirm the diagnosis. This test is called a fetal echocardiogram. […] After birth, a health care provider may think about a diagnosis of a TGA if the baby has blue or gray skin, a weak pulse, or trouble breathing. The care provider may hear a heart sound, called a murmur, while listening to the baby’s heart. […] Tests are needed to confirm a diagnosis of transposition of the great arteries. They may include: […] An echocardiogram also can show if there are other heart problems present at birth, such as a hole in the heart. […] A chest X-ray shows the condition of the heart and lungs. It can’t diagnose TGA by itself, but it does help the health care provider see the heart’s size. […] An ECG can show if the heart is beating too fast, too slow or not at all. […] After surgery to fix TGA, lifelong care is needed with a provider trained in heart problems present at birth. This type of health care provider is called a congenital cardiologist.

• #12 Transposition of the great arteries – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/transposition-of-the-great-arteries/symptoms-causes/syc-20350589

  In transposition of the great arteries, the main arteries leading away from the heart the aorta and the pulmonary artery are switched, also called transposed. […] Transposition of the great arteries (TGA) is a serious, rare heart problem in which the two main arteries leaving the heart are reversed. The condition is present at birth, which means it’s a congenital heart defect. […] Surgery to correct the positions of the arteries is the usual treatment. The surgery is usually done soon after birth. […] Transposition of the great arteries (TGA) may be seen in a baby before birth during a routine pregnancy ultrasound. […] Symptoms of transposition of the great arteries after birth include: Blue or gray skin. Depending on the baby’s skin color, these color changes may be harder or easier to see. Weak pulse. Lack of appetite. Poor weight gain.

• #13 Transposition of the Great Arteries | Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/t/transposition

  Transposition of the great arteries can be diagnosed by a fetal ultrasound. This can be missed on a routine fetal ultrasound. Sometimes, a fetal echocardiogram done by specialists is needed to make a diagnosis of transposition in a fetus. […] After birth, transposition is diagnosed in the first hours or days of life due to cyanosis or low oxygen levels. All babies have a patent ductus arteriosus (PDA) at birth that may allow enough mixing to prevent severe cyanosis. As the ductus arteriosus closes, as it will in the first hours or days of life, cyanosis gets more severe. […] Echocardiography can quickly show the abnormal connections of the great arteries and other features of the cardiac anatomy. This includes the presence and size of an atrial or ventricular septal defect and the branching patterns of the coronary arteries. […] If questions about the anatomy, such as the coronary artery pattern remain, cardiac catheterization or cardiac MRI may be done to get more details of the defect.

• #14 Transposition of the Great Arteries Diagnosis & Treatments | Mount Sinai – New York

  https://www.mountsinai.org/locations/childrens-heart/conditions/transposition-great-arteries

  When your baby is born with a congenital (present at birth) heart disease like transposition of the great arteries (TGA), you will likely go into overdrive to seek the best possible care. […] TGA is often diagnosed in utero, or we may diagnose TGA within the first few hours or days of your baby’s life. […] To diagnose TGA in a newborn baby, our pediatric cardiologist will perform tests, such as: […] Chest X-ray—takes pictures of the your child’s heart, lungs, and blood vessels, and can show if the heart is enlarged […] Echocardiogram (also known as an echo or cardiac ultrasound)—uses ultrasound waves to create an image of the size, shape, and movement of your child’s heart, valves, and chambers. It also shows how blood flows. It is a safe, noninvasive procedure […] Electrocardiogram (ECG or EKG)—records the electrical activity or rhythm of the heart that shows how your child’s heart is beating. It is non-invasive procedure using stickers that are placed on your child’s chest […] Pulse oximetry—monitors the oxygen content of your child’s blood without drawing blood.

• #15 Transposition of the great arteries: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001568.htm

  Transposition of the great arteries (TGA) is a heart defect that occurs from birth (congenital). The two major arteries that carry blood away from the heart — the aorta and the pulmonary artery — are switched (transposed). […] Symptoms appear at birth or very soon afterward. How bad the symptoms are depends on the type and size of additional heart defects (such as atrial septal defect, ventricular septal defect, or patent ductus arteriosus) and how much the blood can mix between the two abnormal circulations. […] The health care provider may detect a heart murmur while listening to the chest with a stethoscope. The baby’s mouth and skin will be a blue color. […] This condition can be diagnosed before birth using a fetal echocardiogram. If not, it is most often diagnosed soon after a baby is born.

• #16 About dextro-Transposition of the Great Arteries (d-TGA) | Congenital Heart Defects (CHDs) | CDC

  https://www.cdc.gov/heart-defects/about/d-tga.html

  Dextro-Transposition (pronounced DECKS-tro trans-poh-ZI-shun) of the Great Arteries or d-TGA is one type of congenital heart defect. Congenital means present at birth. […] d-TGA may be diagnosed during pregnancy or soon after the baby is born. […] During pregnancy, screening tests (prenatal tests) check for birth defects and other conditions. An ultrasound, a tool that creates pictures of the baby, may detect d-TGA. If the health care provider suspects d-TGA from the ultrasound, they can request a fetal echocardiogram to confirm the diagnosis. […] Because the infant with d-TGA might be bluish in color and have trouble breathing, d-TGA is usually diagnosed within the first week of life. The healthcare provider might request additional tests to confirm the diagnosis. The most common test is an echocardiogram, which is an ultrasound of the heart. An echocardiogram can show incorrect positioning of the two large arteries and any irregular blood flow. […] d-TGA can also be detected with newborn pulse oximetry screening. Newborn screening using pulse oximetry can identify some infants with d-TGA before they show any symptoms.

• #17 Transposition of the Great Arteries: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/900574-overview

  Patients with transposition of the great arteries usually present with cyanosis in the newborn period, but clinical manifestations and courses are influenced predominantly by the degree of intercirculatory mixing. […] The mortality rate in untreated patients is approximately 30% in the first week, 50% in the first month, and 90% by the end of the first year. Long-term complications are secondary to prolonged cyanosis and include polycythemia and hyperviscosity syndrome. These patients may develop headache, decreased exercise tolerance, and stroke. […] With improved diagnostic, medical, and surgical techniques, the overall short-term and midterm survival rate exceeds 90%.

• #18 Transposition of the great arteries – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/transposition-of-the-great-arteries/diagnosis-treatment/drc-20350595

  Transposition of the great arteries is most often diagnosed after a baby is born. But sometimes the condition may be seen before birth during a routine pregnancy ultrasound. If so, an ultrasound of the unborn baby’s heart may be done to confirm the diagnosis. This test is called a fetal echocardiogram. […] After birth, a health care provider may think about a diagnosis of a TGA if the baby has blue or gray skin, a weak pulse, or trouble breathing. The care provider may hear a heart sound, called a murmur, while listening to the baby’s heart. […] Tests are needed to confirm a diagnosis of transposition of the great arteries. They may include: […] An echocardiogram also can show if there are other heart problems present at birth, such as a hole in the heart. […] A chest X-ray shows the condition of the heart and lungs. It can’t diagnose TGA by itself, but it does help the health care provider see the heart’s size. […] An ECG can show if the heart is beating too fast, too slow or not at all. […] After surgery to fix TGA, lifelong care is needed with a provider trained in heart problems present at birth. This type of health care provider is called a congenital cardiologist.

• #19 Transposition of the Great Arteries (TGA) – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/congenital-cardiovascular-anomalies/transposition-of-the-great-arteries-tga

  Transposition of the great arteries (in this case, dextro-transposition) occurs when the aorta arises directly from the right ventricle and the pulmonary artery arises from the left ventricle, resulting in independent, parallel pulmonary and systemic circulations; oxygenated blood cannot reach the body except through openings connecting the right and left sides of the heart (eg, patent foramen ovale, ventricular septal defect [VSD]). […] Diagnosis is by echocardiography. […] Diagnosis of transposition of the great arteries is suspected clinically, supported by chest x-ray and ECG, and established by 2-dimensional echocardiography with color flow and Doppler studies. […] On chest x-ray, the cardiac shadow may have the classic egg-on-a-string appearance with a narrow upper mediastinum. ECG shows right axis deviation and right ventricular hypertrophy but may be normal for a neonate.

• #20 Transposition of the great arteries – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube

  https://www.augustahealth.com/disease/transposition-of-the-great-arteries/

  Transposition of the great arteries is most often diagnosed after a baby is born. However, signs of the condition may be detected before birth during a routine pregnancy ultrasound. If so, a fetal echocardiogram may be recommended. A fetal echocardiogram uses sound waves to create detailed images of the unborn baby’s heart. It can help a health care provider confirm the diagnosis of transposition of the great arteries. […] After birth, a health care provider may suspect a heart defect such as transposition of the great arteries if the baby has blue skin, a weak pulse or trouble breathing. […] A physical exam alone can’t accurately diagnose transposition of the great arteries. One or more of the following tests are necessary for an accurate diagnosis: […] Echocardiogram. An echocardiogram is an ultrasound of the heart. It uses sound waves to create moving images of the heart in motion. An echocardiogram can show the position of the aorta and the pulmonary artery. The test can also identify other associated congenital heart defects, such as a ventricular septal defect, atrial septal defect or patent ductus arteriosus.

• #21 Transposition of the Great Arteries – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538434/

  D-TGA can be diagnosed in utero using specialized views of the outflow tracts during fetal ultrasound. […] Imaging is crucial for assessing d-TGA before and after surgical or nonsurgical interventions. The primary objectives of initial imaging are to confirm the diagnosis, detail the anatomy, evaluate hemodynamic abnormalities, assess the degree of mixing between pulmonary and systemic circulations, and identify any associated anomalies. […] Commonly used imaging techniques are listed below. […] Echocardiography: Transthoracic echocardiography is the primary imaging modality for TGA, providing essential information on the morphology, function, and hemodynamics of the ventricles and valves. […] Initial management of patients with d-TGA focuses on ensuring adequate oxygenation. Administration of prostaglandin E1 and balloon atrial septostomy stabilizes patients by maintaining patency of the ductus arteriosus.

• #22 Transposition of the Great Arteries (TGA) – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/congenital-cardiovascular-anomalies/transposition-of-the-great-arteries-tga

  Transposition of the great arteries (in this case, dextro-transposition) occurs when the aorta arises directly from the right ventricle and the pulmonary artery arises from the left ventricle, resulting in independent, parallel pulmonary and systemic circulations; oxygenated blood cannot reach the body except through openings connecting the right and left sides of the heart (eg, patent foramen ovale, ventricular septal defect [VSD]). […] Diagnosis is by echocardiography. […] Diagnosis of transposition of the great arteries is suspected clinically, supported by chest x-ray and ECG, and established by 2-dimensional echocardiography with color flow and Doppler studies. […] On chest x-ray, the cardiac shadow may have the classic egg-on-a-string appearance with a narrow upper mediastinum. ECG shows right axis deviation and right ventricular hypertrophy but may be normal for a neonate.

• #23 Transposition of the great arteries – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube

  https://www.augustahealth.com/disease/transposition-of-the-great-arteries/

  Chest X-ray. Although a chest X-ray doesn’t provide a definitive diagnosis of transposition of the great arteries, it does allow the provider to see the baby’s heart size and determine if blood flow is collecting in the lungs. […] Electrocardiogram (ECG or EKG). This simple, painless test records the electrical activity of the heart. Sticky patches (electrodes) are placed on the chest and sometimes the arms and legs. Wires connect the electrodes to a computer, which displays the test results. An ECG can show if the heart is beating too fast, too slow or not at all.

• #24 Transposition of the Great Arteries – Children’s Health Issues – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/children-s-health-issues/birth-defects-of-the-heart/transposition-of-the-great-arteries

  Transposition of the great arteries is a reversal of the normal connections of the aorta and the pulmonary artery with the heart. […] The diagnosis is based on echocardiography. […] Echocardiography (ultrasonography of the heart) confirms the diagnosis. […] Doctors suspect the diagnosis when they detect very low levels of oxygen in the blood of a newborn. […] The newborn also has rapid but not labored breathing. […] Electrocardiography (ECG) and chest x-rays are typically done. The ECG is usually normal. The chest x-ray may show an enlarged or abnormally shaped heart.

• #25 Transposition of the Great Arteries (TGA) – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/congenital-cardiovascular-anomalies/transposition-of-the-great-arteries-tga

  Transposition of the great arteries (in this case, dextro-transposition) occurs when the aorta arises directly from the right ventricle and the pulmonary artery arises from the left ventricle, resulting in independent, parallel pulmonary and systemic circulations; oxygenated blood cannot reach the body except through openings connecting the right and left sides of the heart (eg, patent foramen ovale, ventricular septal defect [VSD]). […] Diagnosis is by echocardiography. […] Diagnosis of transposition of the great arteries is suspected clinically, supported by chest x-ray and ECG, and established by 2-dimensional echocardiography with color flow and Doppler studies. […] On chest x-ray, the cardiac shadow may have the classic egg-on-a-string appearance with a narrow upper mediastinum. ECG shows right axis deviation and right ventricular hypertrophy but may be normal for a neonate.

• #26 Transposition of the Great Arteries (TGA) | Doctor

  https://patient.info/doctor/transposition-of-the-great-arteries

  Transposition is the most common cyanotic congenital heart lesion presenting in the neonate. It constitutes 3% of all congenital heart disease (CHD) and 20% of all neonatal cyanotic CHD. […] The overall annual incidence is 1 in 4,000 live births. […] Antenatal diagnosis of TGA results in better clinical status before surgery and improved postoperative outcome. […] The prenatal detection rate of TGA on antenatal ultrasound has improved with inclusion of additional outlet views but still remains below 50%. […] Pulse oximetry done on day 1 of life is likely to show low saturations suggesting the possibility of cyanotic heart disease. […] Echocardiography (two-dimensional and colour Doppler) usually provides all the anatomical and functional information needed for diagnosis and management of these babies.

• #27

  https://www.nccs.com.sg/patient-care/conditions-treatments/transposition-of-the-great-arteries

  For adults, diagnosis usually starts with a physical examination by a doctor, assessing your medical history and routine tests. If the doctor hears a heart murmur during the physical examination, he/she might order other tests to confirm the diagnosis of TGA. […] The recommended tests may include: Chest X-ray, Electrocardiogram (ECG), Echocardiogram, Cardiac catheterisation.

• #28 Transposition of the Great Arteries (TGA) – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/topic/default?id=transposition-of-the-great-arteries-tga-90-P01823

  An echo uses sound waves to make a moving picture of the heart and heart valves. This test may show TGA. […] A cardiac catheterization gives detailed information about the structures inside the heart. In this test, a small, thin, flexible tube called a catheter is put into a blood vessel in your childs groin. Then the healthcare provider guides it to your childs heart. Your childs healthcare provider will inject your child with contrast dye to see his or her heart more clearly. This test measures your childs blood pressure and oxygen in the 4 chambers of the heart and the pulmonary artery and aorta. Your child will get medicine to help relax and prevent pain (sedation).

• #29 Transposition of the Great Arteries: Max’s Story | Children’s Hospital of Philadelphia

  https://www.chop.edu/stories/transposition-great-arteries-maxs-story

  As a newborn, Max was diagnosed with transposition of the great arteries (TGA), a life-threatening heart defect. […] The diagnosis of TGA had been confirmed. Cardiac Center nurses and pediatric cardiologist Brian Hanna, MD, explained that Max needed an emergency catheterization procedure, called balloon atrial septostomy or the Rashkind procedure. […] Transposition of the great arteries (TGA) is a complex congenital heart defect. Learn about how it is diagnosed and treated at the CHOP’s Cardiac Center. […] A neonatologist arrived. Juliette and John were able to hold Max for a moment before he was whisked away to the neonatal intensive care unit. The doctor there suspected transposition of the great arteries (TGA), a life-threatening heart defect in which the aorta and the pulmonary artery are attached to the heart in the wrong places.

• #30 Transposition of the Great Arteries | Diagnosis | UK Healthcare

  https://ukhealthcare.uky.edu/gill-heart-vascular-institute/conditions/adult-congenital-heart-disease/transposition-great-arteries/diagnosis

  When TGA is suspected, the diagnosis is confirmed with an echocardiogram (echo). This imaging test uses sound waves to create an image of the heart. […] The physician may also order additional advanced cardiovascular imaging or tests. […] A chest X-ray takes pictures of your heart, lungs and arteries and can reveal signs of heart disease, such as enlarged areas or calcium deposits in your heart and fluid in your lungs. […] An echocardiogram, or echo, records heart activity using high-frequency sound waves, or ultrasound. […] An electrocardiogram (EKG or ECG) provides information about your hearts electrical activity, and can help your provider understand your heart rate and whether you have an arrhythmia. […] Cardiac magnetic resonance imaging (MRI) uses magnets to create detailed images of the hearts structure and show blood flow and heart valve function. […] A stress test measures certain indicators of heart health while stressing your heart through exercise or medications. […] During a cardiac catheterization, a thin tube called a catheter is maneuvered from an opening in the groin to the heart.

• #31 Transposition of the Great Arteries | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/transposition-great-arteries

  Transposition of the great arteries (TGA) is a complex congenital heart defect. […] TGA may be diagnosed before birth using a special ultrasound called a fetal echocardiogram. […] Sometimes TGA is diagnosed a few hours or days after a baby is born. […] Diagnosing TGA may require some or all of these tests: Electrocardiogram (EKG or ECG), which is a record of the electrical activity of the heart; Echocardiogram (also called echo or ultrasound), which is when sound waves create an image of the heart; Chest X-ray; Cardiac MRI, or CT scan, which is a 3D image that shows the heart’s structures in detail. […] Sometimes, cardiac catheterization will be required. A thin, flexible tube (catheter) is inserted through a vein or artery in the leg and into the heart to provide detailed information about the structure and function of the heart and lungs.

• #32 Transposition of the Great Arteries Differential Diagnoses

  https://emedicine.medscape.com/article/900574-differential

  Consider transposition of the great arteries (TGA), particularly in a cyanotic newborn […] Appropriately interpret diagnostic information, including echocardiography, radiography, and oxygenation studies […] Inform patients and caregivers of young children regarding the potential complications of surgery, including death.

• #33 Transposition of the great arteries differential diagnosis – wikidoc

  https://www.wikidoc.org/index.php/Transposition_of_the_great_arteries_differential_diagnosis

  Patients with transposition of the great vessels should be differentiated from other cardiac and non-cardiac causes of cyanosis. […] Transposition of the great arteries should be differentiated from other cyanotic congenital heart diseases found in the pediatrics population. […] Arterial blood gases: Hypoxemia […] Echocardiography may show: Relationship between great vessels […] The classic egg on string appearance.

• #34 Transposition of the Great Arteries – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538434/

  The 2 commonly used surgical procedures for d-TGA are listed below. […] Arterial switch operation: The ASO is the standard procedure for patients with d-TGA who do not have major pulmonic stenosis. […] Surgical repair for d-TGA should be performed within the first week of life. […] Studies report a survival rate exceeding 95% at 15 to 25 years post-discharge. […] A thorough clinical investigation and appropriate imaging studies are essential to differentiate TGA from these conditions and guide management.

• #35 Managing transposition of the great arteries in the womb – Children’s National

  https://innovationdistrict.childrensnational.org/managing-transposition-of-the-great-arteries-in-the-womb/

  Despite the challenging diagnosis for many obstetricians, this fetus heart condition was recognized early by looking at the arteries leaving the heart in addition to the chambers. […] While such a defect is fatal if left untreated, Dr. Donofrio explains there are two pathways that can allow the blood to get to where it needs to go such that the circulation is stabilized and the damage mitigated. […] By keeping those two pathways open, blood can cross from one side of the heart to the other, buying time in the delivery room so that babies can be stabilized before they receive surgery to permanently move the arteries back to their normal position. […] The baby was delivered by Cesarean section in the cardiac operating room at Childrens. […] The cardiac intervention team immediately created a hole where the foramen ovale should have been by using a balloon to open the tissue that had closed. […] The baby is now 1-year-old, Dr. Donofrio says, and is healthya scenario that likely wouldnt have happened had the fetal team not made the diagnosis and continually monitored the condition in the womb. […] Now, we can spot problems early and do something about it.

• #36 Transposition of the Great Arteries (TGA) | Doctor

  https://patient.info/doctor/transposition-of-the-great-arteries

  Once cyanotic heart disease is suspected in a neonate treatment to maintain ductal patency should be started immediately in the form of prostaglandin infusion. […] The definitive corrective procedure is the arterial switch operation, which has replaced the previous procedures focused on achieving a physiological rather than an anatomical correction of circulation in TGA. […] Most full-term neonates with uncomplicated TGA can undergo an arterial switch operation (ASO) as a single operation, with minimal mortality. […] Data confirming that ASO produces excellent long-term results in TGA with low mortality and morbidity and confirming it as the procedure of choice are emerging.

• #37 Transposition of the Great Arteries – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538434/

  D-TGA can be diagnosed in utero using specialized views of the outflow tracts during fetal ultrasound. […] Imaging is crucial for assessing d-TGA before and after surgical or nonsurgical interventions. The primary objectives of initial imaging are to confirm the diagnosis, detail the anatomy, evaluate hemodynamic abnormalities, assess the degree of mixing between pulmonary and systemic circulations, and identify any associated anomalies. […] Commonly used imaging techniques are listed below. […] Echocardiography: Transthoracic echocardiography is the primary imaging modality for TGA, providing essential information on the morphology, function, and hemodynamics of the ventricles and valves. […] Initial management of patients with d-TGA focuses on ensuring adequate oxygenation. Administration of prostaglandin E1 and balloon atrial septostomy stabilizes patients by maintaining patency of the ductus arteriosus.

• #38 Transposition of the Great Arteries: Max’s Story | Children’s Hospital of Philadelphia

  https://www.chop.edu/stories/transposition-great-arteries-maxs-story

  As a newborn, Max was diagnosed with transposition of the great arteries (TGA), a life-threatening heart defect. […] The diagnosis of TGA had been confirmed. Cardiac Center nurses and pediatric cardiologist Brian Hanna, MD, explained that Max needed an emergency catheterization procedure, called balloon atrial septostomy or the Rashkind procedure. […] Transposition of the great arteries (TGA) is a complex congenital heart defect. Learn about how it is diagnosed and treated at the CHOP’s Cardiac Center. […] A neonatologist arrived. Juliette and John were able to hold Max for a moment before he was whisked away to the neonatal intensive care unit. The doctor there suspected transposition of the great arteries (TGA), a life-threatening heart defect in which the aorta and the pulmonary artery are attached to the heart in the wrong places.

• #39 Transposition of the Great Arteries – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538434/

  The 2 commonly used surgical procedures for d-TGA are listed below. […] Arterial switch operation: The ASO is the standard procedure for patients with d-TGA who do not have major pulmonic stenosis. […] Surgical repair for d-TGA should be performed within the first week of life. […] Studies report a survival rate exceeding 95% at 15 to 25 years post-discharge. […] A thorough clinical investigation and appropriate imaging studies are essential to differentiate TGA from these conditions and guide management.

• #40 Transposition of the Great Arteries (TGA)

  https://my.clevelandclinic.org/health/diseases/23387-transposition-of-the-great-arteries

  Transposition of the great arteries is a congenital heart condition that happens when the two main arteries going away from your heart are in the wrong places. […] Your healthcare provider may diagnose transposition of the great vessels during pregnancy. Prenatal tests check for congenital conditions. […] If your provider notices a concern during a prenatal ultrasound, they may recommend a fetal echocardiogram. This noninvasive test is a detailed ultrasound. It can confirm a d-TGA diagnosis. […] To diagnose transposition of the great arteries, providers can use: Echocardiogram (Echo). […] Babies born with the d type of transposition of the great arteries need surgery to survive. Many babies with d-TGA have surgery within the first week of life. Surgeons perform an arterial switch procedure, which involves switching the positions of your babys aorta and pulmonary artery. […] The survival rate after an arterial switch surgery is more than 95%. This survival rate stands even 25 years later.

• #41 Transposition of the Great Arteries – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538434/

  D-TGA can be diagnosed in utero using specialized views of the outflow tracts during fetal ultrasound. […] Imaging is crucial for assessing d-TGA before and after surgical or nonsurgical interventions. The primary objectives of initial imaging are to confirm the diagnosis, detail the anatomy, evaluate hemodynamic abnormalities, assess the degree of mixing between pulmonary and systemic circulations, and identify any associated anomalies. […] Commonly used imaging techniques are listed below. […] Echocardiography: Transthoracic echocardiography is the primary imaging modality for TGA, providing essential information on the morphology, function, and hemodynamics of the ventricles and valves. […] Initial management of patients with d-TGA focuses on ensuring adequate oxygenation. Administration of prostaglandin E1 and balloon atrial septostomy stabilizes patients by maintaining patency of the ductus arteriosus.

• #42 Transposition of the Great Arteries (TGA) | Dayton, Ohio

  https://fetaltonewborn.org/transposition-great-arteries-tga/

  Babies diagnosed with transposition of the great arteries (TGA) (also sometimes known as transposition of the great vessels) are born with a heart defect in which the two main arteries going out of the heart the pulmonary artery and the aorta are switched in position (transposed). The exact cause is unknown. […] Symptoms of TGA normally appear at birth or very soon afterward, and may include: Bluish-purple skin color, Shortness of breath, Trouble with feeding. […] While examining your baby, the doctor will first listen for a heart murmur with a stethoscope. If the doctor hears a heart murmur and your baby is showing symptoms of TGA, any or all of the following tests may be done to confirm the diagnosis: Cardiac catheterization: a procedure where a thin, flexible tube is inserted through a large artery and into the heart, allowing your doctor to see the flow of blood through your babys heart and blood vessels on an X-ray image. This procedure may also be used to create a hole between two of the hearts chambers so that the blood can mix (balloon atrial septostomy). Chest X-ray: a painless test that creates pictures of the heart and lungs. Electrocardiogram (EKG): a painless test that records the hearts electrical activity. Echocardiogram: a painless test that uses sound waves to create a moving picture of the heart. Pulse oximetry: a painless test that shows how much oxygen is in the blood.

• #43 Live-Birth Incidence of Isolated D-Transposition of Great Arteries—The Shift in Trends Due to Early Diagnosis

  https://www.mdpi.com/2075-4418/14/11/1185

  Routine obstetric ultrasound (US) aims to identify suspected cases of CHD so these patients can be referred for full fetal echocardiography. Currently, the question of whether the detection rate (DR) of MCHDs is acceptably high when screening in low-risk pregnancies has remained unanswered. […] TGA is the most representative CHD for the ductal-dependent group. According to some researchers, prenatal diagnosis (PND) is paramount in ductal-dependent CHDs because morbidity and mortality may be reduced. Yet, PND’s role in reducing mortality and long-term morbidity in TGA (doctors’ awareness, emergent neonatal management strategies, balloon atrial septostomy, short-interval ASO) is still debated. […] We aimed to evaluate the incidence, DRs, gestational age at diagnosis, and TOP of isolated D-TGA and assess their trends over time in our unit.

• #44 Transposition of the Great Arteries (TGA) | Doctor

  https://patient.info/doctor/transposition-of-the-great-arteries

  Transposition is the most common cyanotic congenital heart lesion presenting in the neonate. It constitutes 3% of all congenital heart disease (CHD) and 20% of all neonatal cyanotic CHD. […] The overall annual incidence is 1 in 4,000 live births. […] Antenatal diagnosis of TGA results in better clinical status before surgery and improved postoperative outcome. […] The prenatal detection rate of TGA on antenatal ultrasound has improved with inclusion of additional outlet views but still remains below 50%. […] Pulse oximetry done on day 1 of life is likely to show low saturations suggesting the possibility of cyanotic heart disease. […] Echocardiography (two-dimensional and colour Doppler) usually provides all the anatomical and functional information needed for diagnosis and management of these babies.

• #45 Live-Birth Incidence of Isolated D-Transposition of Great Arteries—The Shift in Trends Due to Early Diagnosis

  https://www.mdpi.com/2075-4418/14/11/1185

  We included all cases with suspected or confirmed TGA diagnosis in which a complete consensus about the diagnosis was reached. These cases (resulting in live birth or TOPs, and TOP followed by an informative/documented autopsy or not) were included regardless of the gestational age. […] The prenatal diagnosis of any major CHD always raises the question of whether to terminate or to continue the pregnancy, and this decision will depend on a variety of factors. Currently, TOP is performed in 50–60% of all fetuses with MCHD diagnosed prenatally. […] The main findings of this study are that while the general incidence of TGA was stationary, the live-birth incidence decreased significantly—by 66.66%. Furthermore, comparing the two periods, we found a 5-fold increase in TOP rates. […] The trend highlighted by this study may be related to the introduction of routine FT fetal heart scanning in prenatal screening in our unit in 2013. These results may be influenced by cultural, legal, and health system factors; therefore, they may not be generalizable and should be reassessed in larger studies.

• #46 Live-Birth Incidence of Isolated D-Transposition of Great Arteries—The Shift in Trends Due to Early Diagnosis

  https://www.mdpi.com/2075-4418/14/11/1185

  This is a single tertiary population-based study conducted at a center in southwest Romania. We retrospectively compared data obtained in two periods: January 2008–December 2013 and January 2018–December 2023. The global incidence of the transposition of great arteries in terminated cases, in addition to those resulting in live-born pregnancies, remained almost constant. The live-birth incidence decreased. The median gestational age at diagnosis decreased from 29.3 gestational weeks (mean 25.4) to 13.4 weeks (mean 17.2). The second trimester and the overall detection rate in the prenatal period did not significantly change, but the increase was statistically significant in the first trimester. The proportion of terminated pregnancies in fetuses diagnosed with the transposition of great arteries significantly increased (14.28% to 75%, p = 0.019).

• #47 Live-Birth Incidence of Isolated D-Transposition of Great Arteries—The Shift in Trends Due to Early Diagnosis

  https://www.mdpi.com/2075-4418/14/11/1185

  This is a single tertiary population-based study conducted at a center in southwest Romania. We retrospectively compared data obtained in two periods: January 2008–December 2013 and January 2018–December 2023. The global incidence of the transposition of great arteries in terminated cases, in addition to those resulting in live-born pregnancies, remained almost constant. The live-birth incidence decreased. The median gestational age at diagnosis decreased from 29.3 gestational weeks (mean 25.4) to 13.4 weeks (mean 17.2). The second trimester and the overall detection rate in the prenatal period did not significantly change, but the increase was statistically significant in the first trimester. The proportion of terminated pregnancies in fetuses diagnosed with the transposition of great arteries significantly increased (14.28% to 75%, p = 0.019).

• #48 Echocardiographic Evaluation of Transposition of the Great Arteries – Congenital Cardiac Anesthesia Society

  https://ccasociety.org/education/echoimage/echocardiographic-evaluation-of-transposition-of-the-great-arteries/

  Echocardiographic Evaluation of Transposition of the Great Arteries […] Transposition of the great arteries (TGA) is the most common cyanotic cardiac lesion in newborns, accounting for 5-10% of all congenital heart disease (CHD). […] This review focuses on the use of echocardiography in patients with TGA. […] The important role of echocardiography in patients with TGA is well established. […] The recently published guidelines for multimodality imaging have described in detail the significant contributions of echocardiography in the diagnosis, surgical planning, and long-term surveillance of patients with TGA. […] Fetal cardiac imaging allows for the prenatal diagnosis of TGA but usually requires the expertise of a specialist. […] Transthoracic echocardiography (TTE) plays a major role in characterizing the anatomic and hemodynamic abnormalities in the neonate with transposition and, in most cases, provides all the necessary information for medical management and surgical planning. […] A complete TTE evaluation in the neonate with TGA typically consists of two-dimensional (2D) imaging, Doppler interrogation (pulsed, continuous, and color modalities), M-mode, and tissue Doppler. The diagnosis is based on the sequential segmental analysis that characterizes the detailed assessment of CHD and requires multiple cross-sectional imaging of cardiac and vascular structures. […] The hallmark feature of the interrogation is the demonstration of the presence of concordant atrioventricular connections and discordant ventriculoarterial connections. […] Echocardiography allows for the detailed characterization of associated lesions in TGA such as VSD(s), LVOT obstruction, aortic arch obstruction, and tricuspid valve abnormalities. […] Determining the adequacy of cardiac mixing is one of the most important components of the initial evaluation in the neonate with TGA. […] The specific criterion for determining what constitutes a prepared LV is a controversial topic. […] Echocardiography plays a pivotal role in long-term follow-up by facilitating the identification and characterization of postoperative problems in this patient group.

• #49 Echocardiographic Evaluation of Transposition of the Great Arteries – Congenital Cardiac Anesthesia Society

  https://ccasociety.org/education/echoimage/echocardiographic-evaluation-of-transposition-of-the-great-arteries/

  Echocardiographic Evaluation of Transposition of the Great Arteries […] Transposition of the great arteries (TGA) is the most common cyanotic cardiac lesion in newborns, accounting for 5-10% of all congenital heart disease (CHD). […] This review focuses on the use of echocardiography in patients with TGA. […] The important role of echocardiography in patients with TGA is well established. […] The recently published guidelines for multimodality imaging have described in detail the significant contributions of echocardiography in the diagnosis, surgical planning, and long-term surveillance of patients with TGA. […] Fetal cardiac imaging allows for the prenatal diagnosis of TGA but usually requires the expertise of a specialist. […] Transthoracic echocardiography (TTE) plays a major role in characterizing the anatomic and hemodynamic abnormalities in the neonate with transposition and, in most cases, provides all the necessary information for medical management and surgical planning. […] A complete TTE evaluation in the neonate with TGA typically consists of two-dimensional (2D) imaging, Doppler interrogation (pulsed, continuous, and color modalities), M-mode, and tissue Doppler. The diagnosis is based on the sequential segmental analysis that characterizes the detailed assessment of CHD and requires multiple cross-sectional imaging of cardiac and vascular structures. […] The hallmark feature of the interrogation is the demonstration of the presence of concordant atrioventricular connections and discordant ventriculoarterial connections. […] Echocardiography allows for the detailed characterization of associated lesions in TGA such as VSD(s), LVOT obstruction, aortic arch obstruction, and tricuspid valve abnormalities. […] Determining the adequacy of cardiac mixing is one of the most important components of the initial evaluation in the neonate with TGA. […] The specific criterion for determining what constitutes a prepared LV is a controversial topic. […] Echocardiography plays a pivotal role in long-term follow-up by facilitating the identification and characterization of postoperative problems in this patient group.

• #50 Echocardiographic Evaluation of Transposition of the Great Arteries – Congenital Cardiac Anesthesia Society

  https://ccasociety.org/education/echoimage/echocardiographic-evaluation-of-transposition-of-the-great-arteries/

  Echocardiographic Evaluation of Transposition of the Great Arteries […] Transposition of the great arteries (TGA) is the most common cyanotic cardiac lesion in newborns, accounting for 5-10% of all congenital heart disease (CHD). […] This review focuses on the use of echocardiography in patients with TGA. […] The important role of echocardiography in patients with TGA is well established. […] The recently published guidelines for multimodality imaging have described in detail the significant contributions of echocardiography in the diagnosis, surgical planning, and long-term surveillance of patients with TGA. […] Fetal cardiac imaging allows for the prenatal diagnosis of TGA but usually requires the expertise of a specialist. […] Transthoracic echocardiography (TTE) plays a major role in characterizing the anatomic and hemodynamic abnormalities in the neonate with transposition and, in most cases, provides all the necessary information for medical management and surgical planning. […] A complete TTE evaluation in the neonate with TGA typically consists of two-dimensional (2D) imaging, Doppler interrogation (pulsed, continuous, and color modalities), M-mode, and tissue Doppler. The diagnosis is based on the sequential segmental analysis that characterizes the detailed assessment of CHD and requires multiple cross-sectional imaging of cardiac and vascular structures. […] The hallmark feature of the interrogation is the demonstration of the presence of concordant atrioventricular connections and discordant ventriculoarterial connections. […] Echocardiography allows for the detailed characterization of associated lesions in TGA such as VSD(s), LVOT obstruction, aortic arch obstruction, and tricuspid valve abnormalities. […] Determining the adequacy of cardiac mixing is one of the most important components of the initial evaluation in the neonate with TGA. […] The specific criterion for determining what constitutes a prepared LV is a controversial topic. […] Echocardiography plays a pivotal role in long-term follow-up by facilitating the identification and characterization of postoperative problems in this patient group.

• #51 D-transposition of the great arteries (D-TGA): Anatomy, clinical features, and diagnosis – UpToDate

  https://www.uptodate.com/contents/d-transposition-of-the-great-arteries-d-tga-anatomy-clinical-features-and-diagnosis

  D-transposition of the great arteries (D-TGA): Anatomy, clinical features, and diagnosis […] The anatomy, pathophysiology, clinical features, and diagnosis of D-TGA will be presented here. […] The prevalence of TGA in the United States is estimated to be 2 to 5 per 10,000 live births. TGA accounts for approximately 3 percent of all congenital heart disease (CHD) disorders and almost 20 percent of all cyanotic CHD defects. […] The specific developmental aspects that result in ventriculoarterial discordance in D-TGA are not fully delineated. It is hypothesized that the morphogenesis of D-TGA is due to the abnormal growth and development of the bilateral subarterial conus.

• #52 Understanding Transposition of the Great Arteries – The ObG Project

  https://www.obgproject.com/2016/07/21/transposition-great-arteries-tga/

  Understanding Transposition of the Great Arteries […] This activity is intended for healthcare providers delivering care to women and their families. […] After completing this activity, the participant should be better able to: […] 1. Summarize the structural abnormalities associated with transposition of the great vessels. […] 2. Identify the steps to take after a fetus is diagnosed with transposition of the great vessels on sonogram. […] In Transposition of the Great Arteries (TGA), the pulmonary artery and aorta have changed places (i.e., they are transposed). […] While TGA can be diagnosed prenatally on ultrasound, it may not always be detected. […] In some cases, TGA can be associated with genetic abnormalities and therefore, if a prenatal diagnosis is made or suspected, referral for genetic counseling is recommended, in addition to high risk obstetrical services, neonatology and pediatric cardiology. […] TGA is sometimes referred to as Transposition of the Great Vessels (TGV).

• #53 Transposition of the Great Arteries | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/transposition-of-the-great-arteries

  An echocardiogram is a special ultrasound used by a pediatric heart doctor (cardiologist) to look closely at your baby’s heart and surrounding blood vessels. […] Heart Catheterization: This is a test to measure pressures in the heart. […] Cardiac MRI: A test that uses radio waves, magnets, and a computer to make detailed pictures of the heart and blood vessels. […] The doctors may suggest genetic testing to find out more about this. […] All children born with TGA will need a surgery called an arterial switch to move the blood vessels. […] This surgery is usually done the first week after birth. […] Most of the time, babies with this condition will need surgery a few weeks after they’re born. […] Your baby may stay in the hospital for a couple of days or as long as weeks to months. […] Your cardiologist will follow up with your baby’s heart needs even after they are discharged from the hospital.

• #54 Transposition of the great arteries – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/transposition-of-the-great-arteries/symptoms-causes/syc-20350589

  Transposition of the great arteries occurs during pregnancy when the baby’s heart is developing. The cause is most often unknown. […] Possible complications of complete transposition of the great arteries (D-TGA) may include: Not enough oxygen to body tissues. Unless there’s some mixing of oxygen-rich blood and oxygen-poor blood within the body, this complication causes death. Heart failure. Heart failure is a condition in which the heart can’t pump enough blood to meet the body’s needs. […] Possible complications of congenitally corrected transposition (L-TGA) may include: Reduced heart pumping. In L-TGA, the right lower heart chamber pumps blood to the body. This work is different from what that chamber was designed to do. This can cause changes in how well the heart pumps blood. […] If you had transposition of the great arteries and want to become pregnant, talk with a health care provider first. It may be possible to have a healthy pregnancy, but special care may be needed. […] It’s important to take steps to have a healthy pregnancy. Before becoming pregnant, get recommended immunizations and start taking a multivitamin with 400 micrograms of folic acid.

• #55 Transposition of the Great Arteries – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538434/

  Transposition of the great arteries (TGA) is a congenital cardiac defect characterized by an embryological discordance of the aorta and pulmonary trunk. […] Early diagnosis and surgical intervention, such as the arterial switch operation, are essential for optimal outcomes. […] Evaluation of TGA typically includes imaging modalities such as echocardiography and magnetic resonance imaging to assess cardiac anatomy. […] This activity provides healthcare professionals with an overview of the pathophysiology, clinical presentation, and evidence-based diagnostic and treatment approaches for TGA. […] Identify the clinical manifestations and diagnostic criteria for transposition of the great arteries, both dextro-transposition and congenitally corrected, to facilitate early detection and treatment.

• #56 Transposition of the Great Arteries (TGA)

  https://my.clevelandclinic.org/health/diseases/23387-transposition-of-the-great-arteries

  Transposition of the great arteries is a congenital heart condition that happens when the two main arteries going away from your heart are in the wrong places. […] Your healthcare provider may diagnose transposition of the great vessels during pregnancy. Prenatal tests check for congenital conditions. […] If your provider notices a concern during a prenatal ultrasound, they may recommend a fetal echocardiogram. This noninvasive test is a detailed ultrasound. It can confirm a d-TGA diagnosis. […] To diagnose transposition of the great arteries, providers can use: Echocardiogram (Echo). […] Babies born with the d type of transposition of the great arteries need surgery to survive. Many babies with d-TGA have surgery within the first week of life. Surgeons perform an arterial switch procedure, which involves switching the positions of your babys aorta and pulmonary artery. […] The survival rate after an arterial switch surgery is more than 95%. This survival rate stands even 25 years later.

• #57 Transposition of the Great Arteries – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538434/

  The 2 commonly used surgical procedures for d-TGA are listed below. […] Arterial switch operation: The ASO is the standard procedure for patients with d-TGA who do not have major pulmonic stenosis. […] Surgical repair for d-TGA should be performed within the first week of life. […] Studies report a survival rate exceeding 95% at 15 to 25 years post-discharge. […] A thorough clinical investigation and appropriate imaging studies are essential to differentiate TGA from these conditions and guide management.

• #58 Transposition of the great arteries – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/transposition-of-the-great-arteries/diagnosis-treatment/drc-20350595

  Transposition of the great arteries is most often diagnosed after a baby is born. But sometimes the condition may be seen before birth during a routine pregnancy ultrasound. If so, an ultrasound of the unborn baby’s heart may be done to confirm the diagnosis. This test is called a fetal echocardiogram. […] After birth, a health care provider may think about a diagnosis of a TGA if the baby has blue or gray skin, a weak pulse, or trouble breathing. The care provider may hear a heart sound, called a murmur, while listening to the baby’s heart. […] Tests are needed to confirm a diagnosis of transposition of the great arteries. They may include: […] An echocardiogram also can show if there are other heart problems present at birth, such as a hole in the heart. […] A chest X-ray shows the condition of the heart and lungs. It can’t diagnose TGA by itself, but it does help the health care provider see the heart’s size. […] An ECG can show if the heart is beating too fast, too slow or not at all. […] After surgery to fix TGA, lifelong care is needed with a provider trained in heart problems present at birth. This type of health care provider is called a congenital cardiologist.

• #59 d-Transposition of the Great Arteries | American Heart Association

  https://www.heart.org/en/health-topics/congenital-heart-defects/about-congenital-heart-defects/d-transposition-of-the-great-arteries

  A heart in which the two main arteries carrying blood away from the heart are reversed. […] When a d-transposition occurs, the blood pathway is impaired because the two arteries are connecting to the wrong chambers in the heart. […] Patients with transposition of the great arteries require surgery early in life to survive. […] Two major types of surgery can correct the transposition. […] The second type is called the arterial switch operation. […] Patients who’ve had an atrial switch (e.g., Mustard or Senning operation) may have a serious decline in heart muscle or heart valve function. […] People with repaired transposition, especially those who’ve had the Mustard or Senning operation, are at risk of developing heart rhythm abnormalities (arrhythmias). […] Some patients need more surgery to help their heart pump better, repair abnormal valves or control heart rhythm disturbances.

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