Materiały źródłowe

• #1 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

  All infants with complete transposition of the great arteries (D-TGA) need surgery to correct the heart problem. Treatment for congenitally corrected transposition (L-TGA) depends on when the condition is diagnosed and what other heart conditions exist. […] Before surgery is done to fix the switched arteries, a medicine called alprostadil (Caverject, Edex, others) may be given to the baby. This medicine increases blood flow. It helps oxygen-poor and oxygen-rich blood better mix together. […] Surgery for transposition of the great arteries (TGA) is usually done within the first days to weeks after birth. Options depend on the type of TGA. Not all people with congenitally corrected transposition need surgery. […] Surgeries and other treatments used to treat transposition of the great arteries may include: Atrial septostomy. This treatment may be done urgently as a temporary fix before surgery. It uses thin tubes and small cuts to widen a natural connection between the heart’s upper chambers. It helps mix oxygen-rich and oxygen-poor blood, improving oxygen levels in the baby’s body.

• #2 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/

  Fetal Cardiac Health Monitoring and managing fetuses heart health in the womb can greatly improve their chances of living long and productive lives. […] Case in point: Transposition of the great arteries, a congenital defect characterized by reversal of the hearts two main arteries—the aorta, which distributes oxygenated blood throughout the body, and the pulmonary artery, which carries deoxygenated blood from the heart to the lungs. […] The condition may be fatal if something is not done immediately to reopen the fetal connections to stabilize the circulation before surgery can be done. […] But if the fetal cardiologist can keep tabs on whats happening to the heart over time and prepare a specialty team of cardiologists to treat the problem immediately after birth, chances of survival are significantly improved.

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

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

  The immediate management of an infant with transposition focuses on getting safe oxygen levels. Stable cardiac and pulmonary function is important. […] A continuous infusion of prostaglandin, a medication that will keep the ductus arteriosus open, is usually started when the diagnosis is suspected or confirmed. This will allow some mixing of oxygen-rich blood with oxygen-poor blood. […] A procedure called a „balloon atrial septostomy” is often done once the diagnosis is confirmed. […] Surgical correction of the defect is always needed. In most cases, corrective surgery is done in the first week of life. […] In most cases of transposition, an arterial switch surgery is done. The arterial switch surgery involves cutting off the aorta and pulmonary arteries just above the point where they leave the heart.

• #4 Transposition of the Great Arteries Treatment & Management: Medical Care, Surgical Care, Long-Term Monitoring

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

  Initial treatment of transposition of the great arteries consists of maintaining ductal patency with continuous intravenous (IV) prostaglandin E1 (PgE1) infusion to promote pulmonary blood flow, increase left atrial pressure, and promote left-to-right intercirculatory mixing at the atrial level. This is particularly important in patients with severe left ventricular outflow tract stenosis or atresia. Administration of PgE1 within the first 48 hours after birth is crucial to reduce early mortality in newborns with transposition of the great arteries, especially in the simple form. […] Cardiac catheterization and balloon atrial septostomy is indicated in severely hypoxemic patients with an inadequate atrial level communication and insufficient mixing (preductal saturations significantly lower than postductal saturations). Balloon atrial septostomy is used to increase the atrial level shunt and to improve mixing.

• #5 Transposition of the Great Arteries (TGA)

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

  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. It restores a typical pathway for blood to flow through their heart and out to their body. If your child has a VSD, a surgeon will repair it at the same time using a synthetic patch. […] Your childs care team may use other treatments to delay major surgery for a short time until your baby can handle the procedure better. These include: Prostaglandin: This medication can keep the ductus arteriosus open. This is a blood vessel your baby uses before birth, but it closes after birth because they usually dont need it anymore. Keeping it open allows oxygen-rich blood to flow through your childs body. […] Septostomy procedure: A balloon atrial septostomy uses a catheter (thin tube) to widen the natural opening between the atria (right and left upper chambers in the heart). This minimally invasive procedure allows blood to mix so it can collect oxygen and deliver it to your childs body.

• #6 Transposition of the Great Arteries (TGA) | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/transposition-great-arteries

  Most babies with TGA are born with a small hole between their atria, which allows just enough red blood to get to the body to maintain life for a few hours. Typically diagnosed within the first hours after birth, TGA is life threatening, and in order to survive babies need special therapy urgently. […] The most commonly used initial therapy is balloon atrial septostomy, where a balloon at the end of a catheter (small, flexible tube) is used to enlarge the opening between the atria. Complete open-heart repair generally takes place a few days later. […] After birth, a newborn with transposition of the great arteries (TGA) will be admitted to Boston Children’s Hospital’s cardiac intensive care unit (CICU). Initially, he or she may be placed on oxygen or a ventilator to help with breathing, and IV (intravenous) medications may be given to help the heart and lungs function more efficiently.

• #7 Transposition of the Great Arteries (TGA) in Children | Phoenix Children’s Hospital

  https://phoenixchildrens.org/specialties-conditions/transposition-great-arteries-tga-children

  All children with a TGA will need to have surgery to fix it. […] Typically, in the first two weeks of life, your baby will need surgery for TGA. This procedure is called an arterial switch. Your child’s surgeon will connect the aorta and pulmonary artery to their normal ventricles. The surgeon will also have to move the coronary arteries. The surgeon will also fix any other heart problems, such as a ventricular septal defect, which is a hole in the heart. […] At first, your baby may get the following care: Supplemental oxygen or a ventilator (a machine that helps do the work of breathing for the baby) […] Different types of medicine given by IV. This will help your baby’s heart and lungs work better. […] A medicine called prostaglandin E1. This is used to keep the ductus arteriosus open. This allows blood to flow through the heart until surgery can be done.

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

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

  About one-third of babies born with TGA have extremely low oxygen levels that can harm their bodies and will require an urgent intervention, called a balloon atrial septostomy (BAS), within hours of birth. […] The balloon atrial septostomy was developed here at CHOP by Dr. William Rashkind. This life-saving procedure creates or enlarges a hole between the upper chambers of the heart to allow red (oxygenated) and blue (de-oxygenated) blood to mix. […] All children with transposition of the great arteries will require open heart surgery to treat the defect. Without surgical repair, most babies with TGA will not survive their first year of life. The surgery, known as the arterial switch operation, is typically performed within a few days of birth. […] During an arterial switch operation, a surgeon will reconstruct the heart so that the aorta is attached to the left ventricle and the pulmonary artery is attached to the right ventricle. This restores normal circulation. […] After surgery your child will recover in our Evelyn and Daniel M. Tabas Cardiac Intensive Care Unit (CICU), where they will receive round-the-clock attention from a team of dedicated cardiac critical care medicine specialists.

• #9 Transposition of the Great Arteries (TGA) | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/transposition-great-arteries

  Once stabilized, the baby’s treatments may include: Medication: Doctors may administer an IV (intravenous) medication (prostaglandin E1) to keep open the infant’s ductus arteriosus (the prenatal connection between the aorta and the pulmonary artery, which usually closes shortly after birth, but which is now important as an alternative pathway for blood flow). […] Cardiac catheterization: Before TGA surgery, doctors may perform a cardiac catheterization procedure called balloon atrial septostomy to improve the mixing of oxygen-rich (red) blood and oxygen-poor (blue) blood. A special catheter with a balloon in the tip is used to create or enlarge an opening in the atrial septum (wall between the left and right atria). […] Surgery: Within a baby’s first two weeks, transposition of the great arteries is surgically repaired through a procedure called an arterial switch. While supported by a heart-lung machine, the aorta and pulmonary arteries are disconnected, then switched and reconnected to their proper ventricles. As part of the procedure, the coronary arteries are transferred to the new aorta. In addition, any holes between the chambers of the heart are closed.

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

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

  Transposition of the great arteries treatment and management […] Careful preoperative management is required to minimise the time spent in a hypoxic state. Timed delivery and careful measurement of tissue oxygenation is suggested. […] Once cyanotic heart disease is suspected in a neonate treatment to maintain ductal patency should be started immediately in the form of prostaglandin infusion. Delay in commencing prostaglandins while waiting for echocardiographic confirmation of diagnosis is unacceptable. […] Prompt transfer to a cardiac centre should be arranged, especially for the severely acidotic and cyanosed neonate because most will require urgent atrial septostomy. […] Balloon atrial septostomy (BAS) which was developed by Rashkind nearly half a century ago remains an important part of the management of babies with TGA with intact ventricular septum. It improves mixing of blood at the atrial level by creating or enhancing an atrial communication. BAS may be associated with vascular trauma, atrial arrhythmias, atrial perforation and tamponade.

• #11 Transposition of the Great Arteries – Pediatric Heart Specialists

  https://pediatricheartspecialists.com/heart-education/15-congenital-heart-defects/184-transposition-of-the-great-arteries

  Treatment of Transposition of the Great Arteries involves two phases. The first is immediate stabilization of the patient, followed later by corrective surgery. In many cases, the baby may be gravely ill due to lack of oxygen. The immediate priority is to keep the foramen ovale and ductus arteriosus open to allow mixing of blood between the pulmonary and systemic circulation. The foramen ovale may need to be enlarged by a specialized procedure termed a balloon atrial septostomy. In this procedure, performed via a cardiac catheterization, a balloon tipped catheter is passed from the vein in the groin into the heart, and the foramen ovale is enlarged allowing for better mixing of blood between the atria. This procedure can be performed in the emergency room, in the intensive care unit or in the cardiac catheterization laboratory. Likewise, the ductus arteriosus can be reopened, and maintained open, with an intravenous medication, prostaglandin E1 (PGE1).

• #12 Transposition of the Great Arteries: Diagnosis & Treatment Options – The Kingsley Clinic

  https://thekingsleyclinic.com/resources/transposition-of-the-great-arteries-diagnosis-treatment-options/

  This procedure is typically performed within the first few weeks of life in infants with TGA. It is considered the definitive treatment for TGA and is usually done as soon as the baby is stable enough for surgery. […] Atrial septostomy is typically performed in the first few hours or days of life in infants with TGA who are experiencing severe oxygen deprivation. It is done as a bridge to surgery, helping to stabilize the baby until the arterial switch operation can be performed.

• #13 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

  All infants with complete transposition of the great arteries (D-TGA) need surgery to correct the heart problem. Treatment for congenitally corrected transposition (L-TGA) depends on when the condition is diagnosed and what other heart conditions exist. […] Before surgery is done to fix the switched arteries, a medicine called alprostadil (Caverject, Edex, others) may be given to the baby. This medicine increases blood flow. It helps oxygen-poor and oxygen-rich blood better mix together. […] Surgery for transposition of the great arteries (TGA) is usually done within the first days to weeks after birth. Options depend on the type of TGA. Not all people with congenitally corrected transposition need surgery. […] Surgeries and other treatments used to treat transposition of the great arteries may include: Atrial septostomy. This treatment may be done urgently as a temporary fix before surgery. It uses thin tubes and small cuts to widen a natural connection between the heart’s upper chambers. It helps mix oxygen-rich and oxygen-poor blood, improving oxygen levels in the baby’s body.

• #14 Transposition of the Great Arteries Treatment & Management: Medical Care, Surgical Care, Long-Term Monitoring

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

  Ultimately, the patient requires surgical repair or palliation early in life. […] Surgical approach depends on the age of the patient at presentation, the presence of associated congenital cardiac lesions, and the experience of the cardiothoracic surgeon with a given surgical technique. Most full-term neonates with uncomplicated transposition of the great arteries can undergo an arterial switch procedure in one operation, with minimal mortality. […] The ideal operation is an arterial switch procedure. It represents an anatomic repair and establishes ventriculoarterial concordance. This procedure should be performed when the infant is younger than 4 weeks, as the left ventricle may not be able to handle systemic pressure postoperatively if left too long in the low-pressure, low-resistance pulmonary circuit.

• #15 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

  Arterial switch operation. This is the most common surgery used to correct transposition of the great arteries. During this surgery, the two main arteries leaving the heart are moved to their correct positions. Other heart problems 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 procedure. 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.

• #16 Treatment options for transposition of the great arteries with ventricular septal defect complicated by pulmonary vascular obstructive disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3727366/

  The arterial switch operation is the procedure of choice for patients with isolated transposition of the great arteries or those with associated atrial and/or ventricular septal defects. […] After the development of pulmonary arterial hypertension, the surgical options for patients with a late presentation include either retraining the left ventricle by pulmonary artery banding followed by an arterial switch operation or palliative atrial or arterial switch, with or without medical management of pulmonary hypertension. […] The current indications for an atrial switch procedure include: (1) Infants with isolated TGA (with intact ventricular septum) who present after the neonatal period. The alternative approach is pulmonary artery banding to train the left ventricle followed by arterial switch.

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

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

  The immediate management of an infant with transposition focuses on getting safe oxygen levels. Stable cardiac and pulmonary function is important. […] A continuous infusion of prostaglandin, a medication that will keep the ductus arteriosus open, is usually started when the diagnosis is suspected or confirmed. This will allow some mixing of oxygen-rich blood with oxygen-poor blood. […] A procedure called a „balloon atrial septostomy” is often done once the diagnosis is confirmed. […] Surgical correction of the defect is always needed. In most cases, corrective surgery is done in the first week of life. […] In most cases of transposition, an arterial switch surgery is done. The arterial switch surgery involves cutting off the aorta and pulmonary arteries just above the point where they leave the heart.

• #18 Transposition of the Great Arteries (TGA) | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/transposition-great-arteries

  Once stabilized, the baby’s treatments may include: Medication: Doctors may administer an IV (intravenous) medication (prostaglandin E1) to keep open the infant’s ductus arteriosus (the prenatal connection between the aorta and the pulmonary artery, which usually closes shortly after birth, but which is now important as an alternative pathway for blood flow). […] Cardiac catheterization: Before TGA surgery, doctors may perform a cardiac catheterization procedure called balloon atrial septostomy to improve the mixing of oxygen-rich (red) blood and oxygen-poor (blue) blood. A special catheter with a balloon in the tip is used to create or enlarge an opening in the atrial septum (wall between the left and right atria). […] Surgery: Within a baby’s first two weeks, transposition of the great arteries is surgically repaired through a procedure called an arterial switch. While supported by a heart-lung machine, the aorta and pulmonary arteries are disconnected, then switched and reconnected to their proper ventricles. As part of the procedure, the coronary arteries are transferred to the new aorta. In addition, any holes between the chambers of the heart are closed.

• #19 Transposition of the Great Arteries | Treatment | UK Healthcare

  https://ukhealthcare.uky.edu/gill-heart-vascular-institute/conditions/adult-congenital-heart-disease/transposition-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 dont 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. […] 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.

• #20 Transposition of the Great Arteries (TGA) in Children | Phoenix Children’s Hospital

  https://phoenixchildrens.org/specialties-conditions/transposition-great-arteries-tga-children

  All children with a TGA will need to have surgery to fix it. […] Typically, in the first two weeks of life, your baby will need surgery for TGA. This procedure is called an arterial switch. Your child’s surgeon will connect the aorta and pulmonary artery to their normal ventricles. The surgeon will also have to move the coronary arteries. The surgeon will also fix any other heart problems, such as a ventricular septal defect, which is a hole in the heart. […] At first, your baby may get the following care: Supplemental oxygen or a ventilator (a machine that helps do the work of breathing for the baby) […] Different types of medicine given by IV. This will help your baby’s heart and lungs work better. […] A medicine called prostaglandin E1. This is used to keep the ductus arteriosus open. This allows blood to flow through the heart until surgery can be done.

• #21 Transposition of the Great Arteries Treatment & Management: Medical Care, Surgical Care, Long-Term Monitoring

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

  Ultimately, the patient requires surgical repair or palliation early in life. […] Surgical approach depends on the age of the patient at presentation, the presence of associated congenital cardiac lesions, and the experience of the cardiothoracic surgeon with a given surgical technique. Most full-term neonates with uncomplicated transposition of the great arteries can undergo an arterial switch procedure in one operation, with minimal mortality. […] The ideal operation is an arterial switch procedure. It represents an anatomic repair and establishes ventriculoarterial concordance. This procedure should be performed when the infant is younger than 4 weeks, as the left ventricle may not be able to handle systemic pressure postoperatively if left too long in the low-pressure, low-resistance pulmonary circuit.

• #22 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

  Patients with transposition of the great arteries require surgery early in life to survive. […] Many infants undergo a procedure in the catheterization laboratory to „buy time” and delay the surgery until they can handle it better. […] Two major types of surgery can correct the transposition. […] The first creates a tunnel (baffle) between the atria. […] The second type is called the arterial switch operation. […] Some patients need more surgery to help their heart pump better, repair abnormal valves or control heart rhythm disturbances. […] Patients who had the arterial switch operation may need more surgery to relieve narrowings in the aorta or pulmonary artery where the original surgery was done, or to fix leaky valves. […] Patients who have had the Mustard or Senning operation may need catheterization techniques or surgery to correct abnormalities of the tunnel in the atria, repair abnormal valves or control rhythm disturbances. […] Patients who had the arterial switch operation infrequently may need more surgery to relieve narrowing in the aorta or pulmonary artery where the original surgery was done, or to fix leaky valves.

• #23 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

  Arterial switch operation. This is the most common surgery used to correct transposition of the great arteries. During this surgery, the two main arteries leaving the heart are moved to their correct positions. Other heart problems 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 procedure. 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.

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

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

  Surgery is required for all babies born with d-TGA. This will help maintain, enlarge, or create openings that will deliver oxygen-rich blood to the body. Other procedures may be done before surgery. […] There are two types of surgery to repair d-TGA: […] Arterial Switch Operation. This is the most common procedure and it is usually done in the first month of life. It restores usual blood flow through the heart and out to the rest of the body. During this surgery, the arteries are switched to their usual positions. The pulmonary artery will be moved to arise from the right ventricle and the aorta from the left ventricle. The coronary arteries (small arteries that provide blood to the heart muscle) must also be moved and reattached to the aorta. […] Atrial Switch Operation. This procedure is less commonly performed. During this surgery, the arteries are left in place. However, a tunnel (baffle) is created between the top chambers (atria) of the heart. Although this repair helps blood to go to the lungs and then out to the body, it also makes extra work for the right ventricle to pump blood to the entire body. Therefore, this repair can lead to difficulties later in life.

• #25 Treatment options for transposition of the great arteries with ventricular septal defect complicated by pulmonary vascular obstructive disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3727366/

  The arterial switch operation is the procedure of choice for patients with isolated transposition of the great arteries or those with associated atrial and/or ventricular septal defects. […] After the development of pulmonary arterial hypertension, the surgical options for patients with a late presentation include either retraining the left ventricle by pulmonary artery banding followed by an arterial switch operation or palliative atrial or arterial switch, with or without medical management of pulmonary hypertension. […] The current indications for an atrial switch procedure include: (1) Infants with isolated TGA (with intact ventricular septum) who present after the neonatal period. The alternative approach is pulmonary artery banding to train the left ventricle followed by arterial switch.

• #26 Treatment options for transposition of the great arteries with ventricular septal defect complicated by pulmonary vascular obstructive disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3727366/

  (2) Palliation of patients with pulmonary vascular disease from an associated ventricular septal defect. […] (5) Patients with other complex congenital lesions with VSD, transposition haemodynamics, and severe pulmonary vascular obstructive disease (Current case). […] In the current era, newborns with transposition have a 20-year survival well over 95% after arterial switch operation. […] The arterial switch procedure has become the operation of choice during the neonatal period for management of TGA with or without VSD. […] A palliative arterial switch has some potential advantages over PAS, especially with respect to avoiding late atrial arrhythmias and baffle obstruction; however, long-term results in this setting are not yet available. […] In summary, we report a patient with TGA and a large VSD with Eisenmenger syndrome who underwent a successful palliative atrial switch operation with improvement in functional capacity.

• #27 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. […] Treatment options may involve surgical correction with an arterial switch procedure or palliation with a balloon atrial septostomy. […] 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. […] Rastelli procedure: The Rastelli procedure is indicated for patients with d-TGA, a large VSD, and pulmonary stenosis. […] For ccTGA, a physiological repair strategy that preserves the right ventricle as the systemic ventricle is generally considered safe, but it often results in progressive congestive heart failure (CHF) over time.

• #28 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

  Arterial switch operation. This is the most common surgery used to correct transposition of the great arteries. During this surgery, the two main arteries leaving the heart are moved to their correct positions. Other heart problems 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 procedure. 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.

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

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

  The definitive corrective procedure is the arterial switch operation, which has replaced the previous procedures (Mustard or Senning) 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. […] The alternative is Rastelli procedure which is indicated in patients presenting with D-TGA, a large VSD, and pulmonary stenosis. During this procedure, the VSD is closed using a baffle so oxygenated blood from the left ventricle is directed into the aorta. A conduit is then placed from the right ventricle to the pulmonary artery to shunt deoxygenated blood into the pulmonary artery.

• #30 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

  Arterial switch operation. This is the most common surgery used to correct transposition of the great arteries. During this surgery, the two main arteries leaving the heart are moved to their correct positions. Other heart problems 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 procedure. 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.

• #31 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

  Double switch procedure. This complex surgery is used to treat congenitally corrected transposition. It redirects blood flow coming into the heart. 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 problems. Other surgeries may be needed to fix those heart problems. Surgery also may be needed to treat complications of TGA. If TGA causes changes in the heartbeat, a device called a pacemaker may be recommended. […] 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.

• #32 Pathogenesis and Surgical Treatment of Congenitally Corrected Transposition of the Great Arteries (ccTGA): Part III

  https://www.mdpi.com/2077-0383/13/18/5461

  Congenitally corrected transposition of the great arteries (ccTGA) is an infrequent and complex congenital malformation, which accounts for approximately 0.5% of all congenital heart defects. Most patients have coexisting cardiac abnormalities that require further treatment. Some patients do not require surgical intervention, but most undergo physiological repair leaving the right ventricle in the systemic position, anatomical surgery which restores the left ventricle as the systemic ventricle, or univentricular palliation. Various types of anatomic repair have been proposed for the correction of double discordance. They combine an atrial switch (Senning or Mustard procedure) with either an arterial switch operation (ASO) as a double-switch operation or, in the cases of relevant left ventricular outflow tract obstruction (LVOTO) and ventricular septal defect (VSD), intra-ventricular rerouting by a Rastelli procedure. More recently implemented procedures, variations of aortic root translocations such as the Nikaidoh or the half-turned truncal switch/en bloc rotation, improve left ventricular outflow tract (LVOT) geometry and supposedly prevent the recurrence of LVOTO. Anatomic repair for congenitally corrected ccTGA has been shown to enable patients to survive into adulthood.

• #33 Pathogenesis and Surgical Treatment of Congenitally Corrected Transposition of the Great Arteries (ccTGA): Part III

  https://www.mdpi.com/2077-0383/13/18/5461

  The optimal surgical strategy for ccTGA treatment depends on the specific anatomical structures as well as the prevention and management of heart failure, and requires sufficient individualized consideration. Surgical strategies include physiological correction and anatomical correction. The traditional surgical approach (physiological repair) of ccTGA attempts to restore normal physiology by repairing the associated lesions. It does not address the most serious anatomic abnormalities, mainly ventriculoarterial discordance, and results in long-term outcomes that are less than optimal. Anatomic repair was introduced with the aim to incorporate the left ventricle into the systemic circulation. Due to the excellent short-term and intermediate results of the double-switch operation and its modifications, it has become the procedure of choice for the treatment of ccTGA.

• #34 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

  Double switch procedure. This complex surgery is used to treat congenitally corrected transposition. It redirects blood flow coming into the heart. 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 problems. Other surgeries may be needed to fix those heart problems. Surgery also may be needed to treat complications of TGA. If TGA causes changes in the heartbeat, a device called a pacemaker may be recommended. […] 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.

• #35 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

  Patients with transposition of the great arteries require surgery early in life to survive. […] Many infants undergo a procedure in the catheterization laboratory to „buy time” and delay the surgery until they can handle it better. […] Two major types of surgery can correct the transposition. […] The first creates a tunnel (baffle) between the atria. […] The second type is called the arterial switch operation. […] Some patients need more surgery to help their heart pump better, repair abnormal valves or control heart rhythm disturbances. […] Patients who had the arterial switch operation may need more surgery to relieve narrowings in the aorta or pulmonary artery where the original surgery was done, or to fix leaky valves. […] Patients who have had the Mustard or Senning operation may need catheterization techniques or surgery to correct abnormalities of the tunnel in the atria, repair abnormal valves or control rhythm disturbances. […] Patients who had the arterial switch operation infrequently may need more surgery to relieve narrowing in the aorta or pulmonary artery where the original surgery was done, or to fix leaky valves.

• #36 Transposition of the Great Arteries | Treatment | UK Healthcare

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

  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: A pacemaker, Cardiac catheterization, Medication to improve heart function or manage symptoms.

• #37

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

  Transposition of the great arteries (TGA) needs to be treated by corrective surgery. […] Before babies with TGA undergo their corrective surgeries, doctors might give them medications to increase blood flow and improve the mixing of oxygen-poor and oxygen-rich blood. […] A balloon atrial septostomy might also be performed before these corrective procedures. […] Corrective surgery will treat the transposition of the great arteries (TGA) and this treatment can be carried out soon after the child’s birth. […] There are a few procedures that treat TGA: 1) Arterial Switch Operation. […] 2) Atrial Switch Operation. […] 3) Rastelli procedure. […] Complications after operation should be monitored for and can be treated. […] Medications (ACE inhibitors and beta blockers) can be useful in the event of heart failure. […] Abnormal heart rhythms can be managed with medications or ablation procedures. […] Baffle or conduit stenosis or regurgitation may require intervention with surgery or percutaneous techniques.

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

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

  Although transposition of the great arteries was first described over 2 centuries ago, no treatment was available until the middle of the 20th century, with the development of surgical atrial septectomy in the 1950s and balloon atrial septostomy in the 1960s. These palliative therapies were followed by physiological procedures (atrial switch operation) and anatomic repair (arterial switch operation) (see the videos below). Today, the survival rate for infants with transposition of the great arteries is greater than 90%. […] The prognosis depends on the specific anatomic substrate and type of surgical therapy used (arterial switch operation, atrial switch operation, or Rastelli procedure). Overall, perioperative survival following arterial switch operation is greater than 90%. […] The overall mortality rate following an atrial level switch is low; however, long-term morbidity associated with systemic (right) ventricular dilatation and failure, systemic atrioventricular (tricuspid) valve regurgitation, and atrial bradyarrhythmias and tachyarrhythmias is significant.

• #39 Conditions – Leeds Congenital Hearts

  https://leedscongenitalhearts.com/adult/conditions/view/4/24/transposition-of-the-great-arteries-arterial-switch

  Transposition of the great arteries is a serious heart condition in which the two main arteries arising from the heart are connected to the heart the wrong way round. Babies born with transposition of the great arteries will become blue shortly after birth and without heart surgery, the condition is usually fatal in the first year of life. […] You have had an operation called an Arterial Switch, to switch the arteries back to the correct place in the heart. The coronary arteries, which feed blood to the heart muscle, have to be re-connected. Although this operation is often referred to as corrective surgery, it never makes the heart completely normal. The switch is usually done within the first three weeks after birth. […] The switch operation has been performed since the early 1990s. We are optimistic that life should be normal for most patients who have had a switch procedure but you must have on-going, life-long follow up to monitor for potential problems: These include; Narrowings near the pulmonary valve Leaking of the aortic valve or stretching of the aorta Impaired function of the left pumping chamber, if there was some damage during the operation Problems relating to the coronary arteries.

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

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

  After surgery, medications may be needed to help the heart pump better, control blood pressure, help get rid of extra fluid in the body, and slow down the heart if it is beating too fast. If the heart is beating too slowly, a pacemaker can be used. […] Infants who have surgical repairs for d-TGA are not cured. They may have lifelong complications. A child or adult with d-TGA will need regular follow-up visits with a cardiologist (a heart doctor) to monitor their progress and avoid complications or other health problems. With proper treatment, most babies with d-TGA grow up to lead healthy, productive lives.

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

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

  After surgery, medications may be needed to help the heart pump better, control blood pressure, help get rid of extra fluid in the body, and slow down the heart if it is beating too fast. If the heart is beating too slowly, a pacemaker can be used. […] Infants who have surgical repairs for d-TGA are not cured. They may have lifelong complications. A child or adult with d-TGA will need regular follow-up visits with a cardiologist (a heart doctor) to monitor their progress and avoid complications or other health problems. With proper treatment, most babies with d-TGA grow up to lead healthy, productive lives.

• #42

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

  Transposition of the great arteries (TGA) needs to be treated by corrective surgery. […] Before babies with TGA undergo their corrective surgeries, doctors might give them medications to increase blood flow and improve the mixing of oxygen-poor and oxygen-rich blood. […] A balloon atrial septostomy might also be performed before these corrective procedures. […] Corrective surgery will treat the transposition of the great arteries (TGA) and this treatment can be carried out soon after the child’s birth. […] There are a few procedures that treat TGA: 1) Arterial Switch Operation. […] 2) Atrial Switch Operation. […] 3) Rastelli procedure. […] Complications after operation should be monitored for and can be treated. […] Medications (ACE inhibitors and beta blockers) can be useful in the event of heart failure. […] Abnormal heart rhythms can be managed with medications or ablation procedures. […] Baffle or conduit stenosis or regurgitation may require intervention with surgery or percutaneous techniques.

• #43

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

  Transposition of the great arteries (TGA) needs to be treated by corrective surgery. […] Before babies with TGA undergo their corrective surgeries, doctors might give them medications to increase blood flow and improve the mixing of oxygen-poor and oxygen-rich blood. […] A balloon atrial septostomy might also be performed before these corrective procedures. […] Corrective surgery will treat the transposition of the great arteries (TGA) and this treatment can be carried out soon after the child’s birth. […] There are a few procedures that treat TGA: 1) Arterial Switch Operation. […] 2) Atrial Switch Operation. […] 3) Rastelli procedure. […] Complications after operation should be monitored for and can be treated. […] Medications (ACE inhibitors and beta blockers) can be useful in the event of heart failure. […] Abnormal heart rhythms can be managed with medications or ablation procedures. […] Baffle or conduit stenosis or regurgitation may require intervention with surgery or percutaneous techniques.

• #44 L-Transposition of the Great Arteries

  https://www.rwjbh.org/treatment-care/heart-and-vascular-care/diseases-conditions/congenital-heart-disease/l-transposition-of-the-great-arteries/

  Children and adults with this condition will require regular monitoring for any changes in their condition. If the condition worsens, your doctor may recommend a specific procedure. Some treatment options include: […] Unlike in children with D-Transposition of the Great Arteries, prostaglandin treatment is not necessary at birth. […] Medical and Surgical Procedures include Double switch, Pacemaker implantation or implantable cardioverter defibrillator, Heart transplantation.

• #45 Transposition of the great arteries – Hancock Health

  https://www.hancockhealth.org/mayo-health-library/transposition-of-the-great-arteries/

  Surgeries and other treatments used to treat transposition of the great arteries may include: Atrial septostomy, Arterial switch operation, Atrial switch operation, Rastelli procedure, Double switch procedure. […] 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. […] Due to advances in surgical treatment, most babies with transposition of the great arteries grow up to lead active lives.

• #46 Transposition of the Great Arteries (TGA): Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/pediatrics/heart/transposition-of-the-great-arteries-tga/treatment

  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. […] 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 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.

• #47 Treatment options for transposition of the great arteries with ventricular septal defect complicated by pulmonary vascular obstructive disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3727366/

  (2) Palliation of patients with pulmonary vascular disease from an associated ventricular septal defect. […] (5) Patients with other complex congenital lesions with VSD, transposition haemodynamics, and severe pulmonary vascular obstructive disease (Current case). […] In the current era, newborns with transposition have a 20-year survival well over 95% after arterial switch operation. […] The arterial switch procedure has become the operation of choice during the neonatal period for management of TGA with or without VSD. […] A palliative arterial switch has some potential advantages over PAS, especially with respect to avoiding late atrial arrhythmias and baffle obstruction; however, long-term results in this setting are not yet available. […] In summary, we report a patient with TGA and a large VSD with Eisenmenger syndrome who underwent a successful palliative atrial switch operation with improvement in functional capacity.

• #48 Transposition of the Great Arteries (TGA): Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/pediatrics/heart/transposition-of-the-great-arteries-tga/treatment

  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. […] 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.

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

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

  After surgery, medications may be needed to help the heart pump better, control blood pressure, help get rid of extra fluid in the body, and slow down the heart if it is beating too fast. If the heart is beating too slowly, a pacemaker can be used. […] Infants who have surgical repairs for d-TGA are not cured. They may have lifelong complications. A child or adult with d-TGA will need regular follow-up visits with a cardiologist (a heart doctor) to monitor their progress and avoid complications or other health problems. With proper treatment, most babies with d-TGA grow up to lead healthy, productive lives.

• #50 Transposition of the great arteries (TGA)

  https://teens.aboutkidshealth.ca/transposition-of-the-great-arteries-tga

  Transposition of the great arteries (TGA) is a condition where the arteries connected to the heart are in the wrong spot. […] An operation called an arterial switch is needed to correct this. […] Most cases of TGA are treated with procedures called balloon atrial septostomy and an arterial switch operation. These procedures usually happen when you’re a baby. […] This switch of the great arteries means that blood that is low in oxygen gets pumped around the body instead of blood that is high in oxygen. An open-heart surgery called the arterial switch operation is needed to fix this problem with the heart’s arteries. […] Although the arterial switch is major heart surgery, it is a very successful operation. However, some complications can occur. TGA is a lifelong condition so it’s important to keep seeing your cardiologist.

• #51 Transposition of the Great Arteries (TGA) | Valley Children’s Healthcare

  https://www.valleychildrens.org/services/heart/conditions-we-treat/transposition-of-the-great-arteries

  Transposition of the great arteries (TGA) is a type of heart defect that your baby is born with (congenital). In this condition, the two arteries that carry blood out of the heart arent connected as they should be. They are reversed (transposed). […] Babies can’t live with this condition unless they get treatment. […] All children with a TGA will need to have surgery to fix it. Your baby will likely be admitted to the intensive care unit. […] Typically, in the first two weeks of life, your baby will need surgery for TGA. This procedure is called an arterial switch. Your childs surgeon will connect the aorta and pulmonary artery to their normal ventricles. The surgeon will also have to move the coronary arteries. The surgeon will also fix any other heart problems, such as a ventricular septal defect, which is a hole in the heart. […] Most children who have surgery for this condition will grow and develop normally. Your child will still need to see their providers for checkups. Your child may need additional surgeries or cardiac catheterizations in the future.

• #52 Levo-Transposition of the Great Arteries (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/l-tga.html

  Levo-transposition of the great arteries (L-TGA) is when the positions of the hearts ventricles are reversed. Some people with the condition never need treatment. Others develop symptoms and need treatment with medicines and surgery. […] When treatment is needed, it may include: medicines to help the heart pump better, medicines to prevent fluid buildup in the heart, lungs, and body, cardiac catheterization (a non-surgical procedure), a pacemaker, heart surgery. […] A baby born with L-TGA may not need treatment right away. Some children never need treatment.

• #53 Transposition of the Great Arteries: Symptoms & Treatment – Victor Chang Cardiac Research Institute

  https://www.victorchang.edu.au/heart-disease/transposition-of-the-great-arteries

  Babies with dextro transposition of the great arteries (D-TGA) will need surgery in the first few weeks of life. The most common surgery performed is known as an arterial switch operation, where the arteries are switched to ensure normal blood flow. […] Until surgery can be performed, the condition may be managed through: medication […] balloon atrial septostomy (BAS) where a catheter (thin tube) is used to widen the opening between the upper chambers of the heart (atria), allowing oxygen-rich and oxygen-poor blood to mix together and improve blood oxygen levels in the body. […] Treatment for levo transposition of the great arteries (L-TGA) will depend on severity of symptoms and whether there are other heart conditions or defects present. […] TGA commonly occurs in conjunction with other heart defects that may also require surgery and further treatment.

• #54 l-Transposition of the Great Arteries | American Heart Association

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

  Transposición de las grandes arterias […] Most children without a VSD or pulmonary valve obstruction won’t need surgery. Children with these problems may require surgery to close the hole, relieve the blockage of blood flow to the lungs, and in some cases repair or replace the leaky tricuspid valve. […] A first surgery or repeat surgery may be needed in adulthood. For example, the tricuspid valve may become leaky and need to be replaced. There are rare patients who may benefit from a complex procedure called a „double switch.” […] Most patients with l-transposition have not had prior surgery and will never require surgery. Some patients need surgery to repair abnormal valves or control heart rhythm disturbances. Patients who still have a ventricular septal defect and pulmonary stenosis may benefit from surgery, which should be performed by a heart surgeon with a great deal of experience in congenital heart defects.

• #55 Levo-Transposition of the Great Arteries (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/l-tga.html

  Levo-transposition of the great arteries (L-TGA) is when the positions of the hearts ventricles are reversed. Some people with the condition never need treatment. Others develop symptoms and need treatment with medicines and surgery. […] When treatment is needed, it may include: medicines to help the heart pump better, medicines to prevent fluid buildup in the heart, lungs, and body, cardiac catheterization (a non-surgical procedure), a pacemaker, heart surgery. […] A baby born with L-TGA may not need treatment right away. Some children never need treatment.

• #56 L-Transposition of the Great Arteries

  https://www.rwjbh.org/treatment-care/heart-and-vascular-care/diseases-conditions/congenital-heart-disease/l-transposition-of-the-great-arteries/

  Children and adults with this condition will require regular monitoring for any changes in their condition. If the condition worsens, your doctor may recommend a specific procedure. Some treatment options include: […] Unlike in children with D-Transposition of the Great Arteries, prostaglandin treatment is not necessary at birth. […] Medical and Surgical Procedures include Double switch, Pacemaker implantation or implantable cardioverter defibrillator, Heart transplantation.

• #57 Congenitally Corrected Transposition of the Great Arteries – Pediatrics – Merck Manual Professional Edition

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

  Pacemakers are generally required if patients have AV block, and adults with moderate to severe RV dysfunction and risk for ventricular arrhythmias may receive implantable cardioverter defibrillators. […] Patients with severe manifestations, including progressive cardiomyopathy due to RV dysfunction, may require heart transplantation. […] Treatment is with a combination of medical, surgical, and rhythm device modalities.

• #58 Congenitally Corrected Transposition of the Great Arteries – Pediatrics – Merck Manual Professional Edition

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

  Pacemakers are generally required if patients have AV block, and adults with moderate to severe RV dysfunction and risk for ventricular arrhythmias may receive implantable cardioverter defibrillators. […] Patients with severe manifestations, including progressive cardiomyopathy due to RV dysfunction, may require heart transplantation. […] Treatment is with a combination of medical, surgical, and rhythm device modalities.

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

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

  Transposición de las grandes arterias […] Most children without a VSD or pulmonary valve obstruction won’t need surgery. Children with these problems may require surgery to close the hole, relieve the blockage of blood flow to the lungs, and in some cases repair or replace the leaky tricuspid valve. […] A first surgery or repeat surgery may be needed in adulthood. For example, the tricuspid valve may become leaky and need to be replaced. There are rare patients who may benefit from a complex procedure called a „double switch.” […] Most patients with l-transposition have not had prior surgery and will never require surgery. Some patients need surgery to repair abnormal valves or control heart rhythm disturbances. Patients who still have a ventricular septal defect and pulmonary stenosis may benefit from surgery, which should be performed by a heart surgeon with a great deal of experience in congenital heart defects.

• #60 D-transposition of the great arteries (D-TGA): Management and outcome – UpToDate

  https://www.uptodate.com/contents/d-transposition-of-the-great-arteries-d-tga-management-and-outcome

  D-transposition of the great arteries (D-TGA): Management and outcome […] The management and outcome of D-TGA will be presented here. […] Prenatal diagnosis of D-TGA improves survival as it allows for delivery at a tertiary center where pediatric cardiologists can make timely postnatal decisions regarding prostaglandin (alprostadil) infusion and the need for a balloon atrial septostomy (BAS) (figure 2) [1]. […] When the diagnosis of D-TGA is made prenatally, delivery should occur at a facility with a level III neonatal intensive care unit and pediatric cardiology expertise.

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

  https://www.chop.edu/centers-programs/cardiac-center/managing-transposition-great-arteries

  The Cardiac Center at CHOP is happy to provide several resources to assist healthcare professionals in managing patients carrying fetuses with suspected transposition of the great arteries (TGA). […] Transposition of the great arteries is unpredictable. At least one-third of newborns with the condition will require urgent intervention within hours of birth. The balloon septostomy procedure used to treat TGA was developed at CHOP. […] Surgery to treat TGA is complex and requires a highly experienced team, from prenatal management to surgery and intensive care. TGA outcomes are best at centers that treat a high volume of TGA cases, such as the Cardiac Center at CHOP, where volumes and outcomes are among the best.

• #62 Get Transposition of the Great Arteries Care | Cleveland Clinic Children’s

  https://my.clevelandclinic.org/pediatrics/services/transposition-of-the-great-arteries-treatment

  As your child grows, theyll regularly see our cardiology team, wholl keep an eye on their progress with regular echocardiograms, EKGs and exercise stress tests. And once your child reaches adulthood, well help them move comfortably to care with our adult congenital heart condition specialists. […] Your childs social and emotional health is also important. Well provide you with community resources and mental healthcare for your child, if needed. Our social workers, child life specialists and other team members support you and your child throughout their treatment.

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