Transposition of the Great Arteries (TGA)

Transposition of the great arteries (TGATransposition of the great arteries (TGA)) is the most common neonatal cyanotic congenital cardiac lesion. The parallel and separate circulations require the presence of an intracardiac lesion to ensure mixing and adequate systemic oxygenation, which is promoted by PDAPersistent ductus arteriosus (PDA) flow to increase left atrial pressure. Associated lesions may include different coronary arteryCoronary artery patterns, ventricular septal defectVentricular septal defect (VSD), pulmonary tract obstruction, and arch obstruction. Fetal diagnosis allows for co-ordination of delivery at or in close proximity to a cardiac intensive care unit with access to interventional cardiology. Severe postnatal hypoxemia necessitates immediate evaluation for a balloon atrial septostomy. Surgical correction of TGATransposition of the great arteries (TGA) with intact ventricular septum with an arterial switch operation (ASO) typically occurs within the first 10 days of life. Timing of repair of TGATransposition of the great arteries (TGA) with VSDVentricular septal defect (VSD) depends on size and number of VSDVentricular septal defect (VSD) and associated lesions; simple VSDVentricular septal defect (VSD) is managed similar to TGA/IVS but complex TGA may need a staged approach. The ASO for TGATransposition of the great arteries (TGA) with intact ventricular septum has > 98% survivalSurvival and excellent long-term outcomes; excellent outcomes are also seen for TGA with isolated VSDVentricular septal defect (VSD) surgery. Increased risk is encountered with coronary artery anomaliesCoronary artery anomaly. Treatment of TGA/VSDVentricular septal defect (VSD) with additional lesions are contingent on underlying anatomy and residual lesions. TGA/VSDVentricular septal defect (VSD) with obstruction to systemic outflow requires early corrective surgery or palliation. Repair of TGA/VSDVentricular septal defect (VSD) with pulmonary stenosisPulmonary Stenosis are generally deferred for several months toLecompte procedure decrease risk for a RastelliRastelli or Nakaidoh operation.